Modifiers

Use this procedure to view a list of modifiers appropriate for use with your selected code, along with descriptions and CCI validity, appropriate for your client type and date of service.

Note: The CCI Policy Manual states: " These modifiers have been designated specifically for use with the correct coding and mutually exclusive code pairs...It is very important that NCCI-associated modifiers only be used when appropriate. In general these circumstances relate to separate patient encounters, separate anatomic sites or separate specimes...NCCI-associated modifiers should not be used to bypass an NCCI edit unless the proper criteria for use of the modifier are met. Documentation in the medical record must satisfy the criteria required by any NCCI-associated modifier used." The list provided is to be used as a guide only and is not all inclusive. As with all CPT and ICD-9 coding, physician/provider documentation of medical necessity is the key to coding correctly. The information provided is based on our technical researchers, contracted employees, and actual links from Medicare contractors.

Procedure

  1. Type a code in the Search field. You can also select a code from Search.
  1. Select the Modifiers icon . The detail page opens.

Note: The options by default are set to show you all valid modifiers appropriate for your code, part, and date of service.

  1. Choose your settings from the Options section:
  • Choose a Medicare option of Fac or Pro
  • Show All or Only CCI Valid
  1. Click Submit.
  • The Modifier column shows the modifier. Click the modifier to open a new tab and view modifier details.
  • The Description column shows the modifier’s standard description.
  • The CCI Valid column shows you if the modifier can be potentially used to resolve CCI conflicts.
  • The Notes column gives you access to any notes that you or your clinic has entered for this modifier. Click on the note icon to view or change notes.