Modifiers
This section describes modifiers used for HCFA or UB claims.
** Approved for Hospital Outpatient Use Level 1 (CPT)
|
Modifier |
Description |
|
21 |
Prolonged evaluation and management services |
|
22 |
Unusual procedural services |
|
23 |
Unusual anesthesia |
|
24 |
Unrelated evaluation and management service by the sane physician during a post-operative period. |
|
26 |
Professional component |
|
27 |
Multiple OP encounter |
|
32 |
Mandated services |
|
47 |
Anesthesia by surgeon |
|
51 |
Multiple procedures |
|
53 |
Discontinued procedure |
|
54 |
Surgical care only |
|
55 |
Postoperative management only |
|
56 |
Preoperative management only |
|
57 |
Decision for surgery |
|
62 |
Two surgeons |
|
63 |
Procedure performed on infants |
|
66 |
Surgical team |
|
73 |
Discontinued OP proc. prior to anesthesia |
|
74 |
Discontinued OP proc. after anesthesia |
|
79 |
Unrelated procedure or service by the same physician during the postoperative period. |
|
80 |
Assistant surgeon |
|
81 |
Minimum assistant surgeon |
|
82 |
Assistant surgeon when qualified surgeon is not available. |
|
90 |
Reference (outside) laboratory |
|
91 |
Repeat clinical diagnostic laboratory test |
|
99 |
Multiple modifiers |
|
25 ** |
Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other procedure. |
|
50 ** |
Bilateral procedure |
|
52 ** |
Reduced services |
|
58 ** |
Staged or related procedure or service by the same physician during the postoperative period. |
|
59 ** |
Distinct procedural service |
|
76 ** |
Repeat procedure by the same physician |
|
77 ** |
Repeat procedure by the another physician |
|
78 ** |
Return to the operating room for a related procedure during the postoperative period |
|
TC |
Technical Component |