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Medical Billing Modifiers List Pdf
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Sharing such data may be considered a “sale” of information under the California Privacy Act. Opting out of personalized advertising opts you out of these “sales.” Learn more in our Privacy Policy, Help Center, and Cookies and Similar Technology Policy.1 General Guidelines Rank Modifiers Item Modifiers Reference Guide A. Price Modifiers B. Statistical Modifiers Affecting Prices C. Statistical/Information Modifiers Level 1 – CPT- 4 Modifier Level 2 – HCPCS Alpha-Numeric Modifier Ambulance Origin and Destination Modifiers 2003 HCPCS Modifier Delete/Add 2004 HCPCS Modifier Delete/Add General Instructions A 2-digit modifier can be used to further describe a service or procedure. The Transducer Reference Manual lists Class I (CPT-4), Class II (cpt-4 alpha non-digital), and Class III (local) transducers. Level I and II modifier definitions are available in the Healthcare Common Procedural Coding System (HCPCS). Level III modifiers are defined by the financial intermediary and can only be added with the approval of the Centers for Medicare and Medicaid Services (CMS). Modifiers can be replaced with any code level. There are two change fields on the Medicare claim form for rank-changers (item 24d). When entering only one variable, enter it in the first variable.
2 When entering a price modifier, enter it only in the first variable. For example, when billing for a professional component (26) or technical component (TC), enter the 26 or TC modifier in the first modifier field. When entering price modifiers and statistical modifiers affecting price, enter the price modifier in the first variable field and the statistical modifier affecting price in the second variable field. For example, when accounting for the occupational component (modifier 26) in the Health Professional Shortage Area (HPSA) (modifier QB), enter 26 in the first modifier field and QB in the second modifier field. When entering price-affecting statistical modifiers and statistical/informational modifiers, enter the statistical modifiers in the first field and the statistical/informational modifiers in the second field. For example, enter 26 in the first variable field and 76 in the second variable field for professional components (counter 26) and repeated procedures by the same physician (modifier 76). When entering more than one statistical/informative modifier that does not affect price, it does not matter which modifier is entered first. Exceptions are QT, QW and SF modifiers. These three modifiers are valid only in the first variable field. When applying more than four modifiers, enter 99 modifiers in the first variable field. In the statement field (item 19 of the application form), list all the modifiers in the correct order, and confirm which substring or sequence code the modifiers belong to. Modifier Items When more than one modifier is submitted, the modifiers must be listed in sequence. The following items are a reference point when ranking modifiers. A. The price modifier is considered by CMS as part of the seven-digit procedure code and is used to determine the appropriate fee or charge for the service. * TC * 26 B. * Indicates modifiers that match only the first modifier field. C. Statistical Modifiers That Affect Pricing Are Added to Procedure Codes and Cause Fees or Charges to Change in the Same Way Every Time for a Billed Code.
3 * AA * AD AH AJ AS GM QB * QK QU * QX * QY QZ SG * UN * UP * UQ * UR * US D. E. Used for statistical/data modifier files that affect the processing or payment of a billed code. AT F1 G1 GC GW Q3 QM * SF VP 79 AM F2 G2 GE GY Q4 QN T1 23 * 90 CC F3 G3 GG GZ Q5 QP T E1 F4 G4 GH KO Q6 QQ T3 25 E2 F5 G5 GJ KP Q7 QS T4 32 E3 F6 G6 GN KQ Q8 * QT T5 47 E4 F7 G7 GO LC Q9 QV T6 57 EJ F8 G8 GP LD QA * QW T7 58 EM F9 G9 GQ LR QC RC T8 59 EP FA GA GT LS QD RP T9 76 ET FP GB GV LT QL RT TA 77 F. * Indicates modifiers that match only the first modifier field. Level I – CPT-4 Modifier 21- Prolonged E&M Services: When the face-to-face or floor/site service(s) provided are prolonged or otherwise, the highest level of evaluation and management (E&M) is usually required. ) of a particular type of service. 22-Extraordinary Order Service: When the service provided is more than the order normally specified. Note: This modifier is not used to report procedures complicated by late effects of previous surgery, radiation, infection, and very low severity, including scarring, scarring, and/or alteration of normal markings.
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4 (Newborns and infants less than 10 kg.) or trauma. 23. General anesthesia: Occasionally, a procedure requiring general anesthesia or local anesthesia must be performed under general anesthesia because of the unusual circumstances. 24. Unrelated E&M Services, Same Physician, Postoperative Period: The physician may indicate that E&M services were performed postoperatively for reasons unrelated to the original procedure. 25.Same Day Procedures or Other Services by the Same Physician for Essential, Identifiable E&M Services: The physician may indicate that the procedure or service specified by the CPT code is required on the same day by the same physician for the patient’s medical condition. Other services provided as essential, separately identifiable E&M services and general intraoperative and postoperative care associated with additional procedures. E&M services may be due to the symptoms or conditions for which the procedure is offered. As such, different diagnoses are not required to report E&M services on the same day. This condition can be reported by adding modifier 25 to the appropriate level of E&M service. * 26- Professional component: Some procedures are a combination of medical component and technical component. When physician components are reported separately, services can be identified by adding a generic 26 modifier
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