Modifiers for Medicare Billing
For Medicare purposes, modifiers are two-digit codes appended to procedure codes and/or HCPCS codes, to provide additional information about the billed procedure. In some cases, addition of a modifier may directly affect payment. Below is a list of modifiers including the modifier description and/or instructions and whether the modifier affects the Medicare payment.Ambulance Claim Modifiers
Modifiers that are used on claims for ambulance services are created by combining two alpha characters. Each alpha character, with the exception of X, represents an origin (source) code or a destination code. The pair of alpha codes creates one modifier. The first position alpha code = origin; the second position alpha code = destination.
Origin and destination codes and their descriptions are listed below:
D |
Diagnostic or therapeutic site other than "P" or "H"
when these are used as origin codes |
E
|
Residential, domiciliary, custodial facility (other than an
1819 facility) |
G
|
Hospital based dialysis facility (hospital or hospital related) |
H
|
Hospital |
I
|
Site of transfer (e.g., airport or helicopter pad) between
modes of ambulance transport |
J
|
Non-hospital based dialysis facility |
N
|
Skilled nursing facility (SNF) (1819 facility) |
P
|
Physician's office (includes HMO non-hospital facility, clinic,
etc.) |
R
|
Residence |
S
|
Scene of accident or acute event |
X
|
(Destination code only) Intermediate stop at physician's office
in route to the hospital (includes HMO non-hospital facility,
clinic, etc.) |
GM
|
Multiple patients on one ambulance trip |
QL
|
Patient pronounced dead after ambulance called |
QM
|
Ambulance service provided under arrangement by a provider of
services* |
QN
|
Ambulance service furnished directly by a provider of services* |
Anesthesia Code Modifiers
AA
|
Anesthesia services personally performed by anesthesiologist
- Distinct fee schedule amount. Affects payment. |
AD |
Medical supervision by a physician: More than 4 concurrent
anesthesia procedures -. Distinct fee schedule amount. Affects
payment. |
G8 |
Monitored anesthesia care (MAC) for deep complex,
complicated, or markedly invasive surgical procedure |
G9 |
Monitored anesthesia care (MAC) for deep complex,
complicated, or markedly invasive surgical procedure |
QK
|
Medical direction of 2, 3 or 4 concurrent anesthesia
procedures involving qualified individuals - 1999 services
limits the payment to 50% of the amount that would have been
allowed if personally performed by a physician or non-supervised
CRNA. |
QS
|
Monitored anesthesia care- No effect on payment. For
informational purposes only. Must be used in conjunction with a
pricing anesthesia modifier. |
QX
|
CRNA service with medical direction by physician- 1999
services limits the payment to 50% of the amount that would have
been allowed if personally performed by physician or
non-supervised CRNA. |
QY
|
Medical direction of one certified registered nurse
anesthetist (CRNA) by an anesthesiologist. |
QZ
|
CRNA service without medical direction by a physician -
No effect on payment. Payment is equal to the amount that would
have been allowed if personally performed by a physician. |
23
|
Unusual anesthesia - Used to report a procedure which
usually requires either no anesthesia or local anesthesia;
however, because of unusual circumstances must be done under
general anesthesia. Coverage /payment will be determined on a
"by-report" basis. |
47
|
Anesthesia by surgeon - Used to report regional or
general anesthesia provided by the surgeon (Not covered by
Medicare). |
Clinical Research Studies
Q0 (zero) |
Investigational clinical service provided in a clinical
research study that is in an approved clinical research study |
Q1 |
Routine clinical service provided in a clinical research study
that is in an approved clinical research study |
Coronary Angioplasty, Atherectomy and Stent Procedures (CPT codes 92980, 92981, 92982, 92984, 92996)
LC |
Left circumflex coronary artery |
LD |
Left anterior descending coronary artery |
RC |
Right coronary artery |
Diagnostic Procedures/Laboratory Modifiers
GG |
Diagnostic Mammography - Performance and payment of a
screening mammography and diagnostic mammography on same patient,
same day. (Moved from other section/alpha order) |
LT |
Left Side - Used to identify procedures performed on the
left side of the body. No effect on payment; however, failure to
use when appropriate could result in delay or denial (or partial
denial) of the claim. |
RT |
Right Side - Used to identify procedures performed on
the right side of the body. No effect on payment; however, failure
to use when appropriate could result in delay or denial (or
partial denial) of the claim. |
LR |
Laboratory Round Trip - No effect on payment |
QP |
Panel test - Documentation is on file showing that the
laboratory test(s) was ordered individually or ordered as a
CPT-recognized panel other than automated profile codes
80002-80019, G0058, G0059, and G0060. No effect on payment- but
may assist with medical necessity determinations. |
QW |
CLIA Waived Test - Effective October 1, 1996, all new
waived tests are being assigned a CPT code (in lieu of a temporary
five-digit G- or Q-code). The CPT code should be billed with a
modifier QW by entities holding a Certificate of Waiver. |
TC |
Technical component only - Use to indicate that the
technical or professional component is reported separately (from
the professional component) for the diagnostic procedure
performed. The fee schedule contains different payment amounts for
technical components. Affects payment. |
UN |
Portable X-ray Modifiers; two patients |
UP |
Portable X-ray Modifiers; three patients |
UQ |
Portable X-ray Modifiers; four patients |
UR |
Portable X-ray Modifiers; five patients |
US |
Portable X-ray Modifiers; six patients |
26 |
Professional component only - Use to indicate that the
physician component is reported separately (from the technical
component) for the diagnostic procedure performed. The fee
schedule contains different payment amounts for professional
components. Affects payment. |
90 |
Reference lab - Used to indicate a lab test sent to a
referral (outside) lab, e.g., lab procedure performed by a party
other than the treating or reporting laboratory. Note: Referral
lab name, address and/or PIN must be included with the claim. No
effect on payment. |
91 |
Repeat clinical diagnostic laboratory test - in the
course of treatment of the patient, it may be necessary to repeat
the same laboratory test on the same day to obtain subsequent
(multiple) test results. Under these circumstances, the laboratory
test performed can be identified by its usual procedure number and
the addition of the modifier -'91'. Note: This modifier may not be
used when test are rerun to confirm initial results; due to
testing problems with specimens or equipment; or for any other
reason when a normal, one-time, reportable result is all that is
required. This modifier may not be used when other code(s)
describe a series of test results (e.g., glucose tolerance test,
evocative/suppression testing). This modifier may only be used for
laboratory test(s) performed more than once on the same day on the
same patient. |
End Stage Renal Disease (ESRD) Modifiers
AX |
Item furnished in conjunction with dialysis services. |
CB |
Services ordered by a dialysis facility physician as part of
the ESRD beneficiary's dialysis benefit. |
CD |
AMCC test has been ordered by an ESRD facility or MCP physician
that is part of the composite rate and is not separately billable |
CE |
AMCC test has been ordered by an ESRD facility or MCP physician
that is a composite rate test but is beyond the normal frequency
covered under the rate and is separately reimbursable based on
medical necessity |
CF |
AMCC test has been ordered by an ESRD facility or MCP physician
that is not part of the composite rate and is separately billable |
EJ |
Subsequent claims for a defined course of therapy, e.g., EPO,
sodium hyaluronate, infliximab |
EM |
Emergency reserve supply (for ESRD benefit only) - No effect on
payment. |
G1 |
Most recent URR reading of less than 60 |
G2 |
Most recent URR reading of 60 to 64.9 |
G3 |
Most recent URR reading of 65 to 69.9 |
G4 |
Most recent URR reading of 70 to 74.9 |
G5 |
Most recent URR reading of 75 or greater |
G6 |
ESRD patient for whom less than seven dialysis sessions have
been provided in a month |
Evaluation/Management Code Modifiers
AI |
Principal Physician of Record. Used by the admitting or
attending physician who oversees the patient's care, as distinct
from other physicians who may be furnishing specialty care
|
24 |
Unrelated E/M service during a post op period - Use with
E/M codes only to indicate that the E/M service was performed
during a postoperative period for a reason(s) unrelated to the
original procedure. Modifier 24 applies to unrelated E/M services
for either MAJOR or MINOR surgical procedure. Failure to use this
modifier when appropriate may result in denial of the E/M service. |
25 |
Significant, separately identifiable - Evaluation and
Management service by the same physician on the same day as the
procedure or other service. The physician may need to indicate
that on the day a procedure or service was performed, the
patient's condition required a significant, separately
identifiable E&M service above and beyond the other service
provided or beyond the usual preoperative and postoperative care
associated with the procedure that was performed. The E&M
service may be prompted by the symptom or condition for which the
procedure and/or service was provided. As such, different
diagnoses are not required for reporting of the E&M services
on the same date. This circumstance may be reported by adding the
modifier -25 to the appropriate level of E&M service. |
57 |
Decision for surgery - Use with E/M codes billed by the
surgeon to indicate that the E/M service resulted in the decision
for surgery (E/M visit was NOT usual preoperative care).For E/M
visits prior to MAJOR surgery (90-day post op period) only.
Failure to use this modifier when appropriate may result in denial
of the E/M service. |
National modifiers were established to allow the class findings to be reported without writing a narrative description. The following modifiers should be used in conjunction with "covered routine" foot care procedures (e.g., 11055, 11056, 11057, 11719) to indicate the severity of the patient's systemic condition.
Q7 |
One CLASS A finding |
Q8 |
Two CLASS B findings |
Q9 |
One CLASS B and two CLASS C findings |
AS |
Physician Assistant, Nurse Practitioner, or Clinical Nurse
Specialist services for assistant-at-surgery, non-team member.
Reimburses at the Non Physician practitioner rate of 85% of the
Medicare Physician Fee Schedule, then Assistant at surgery rate of
16% of the calculated non physician practitioner rate. |
GO |
Services delivered under an outpatient occupational therapy
plan of care. |
AP |
Determination of refractive state was not performed in the
course of diagnostic ophthalmological examination. No effect on
payment. |
AQ |
Physician providing a service in an unlisted health
professional shortage area (HPSA). For dates of service on or
after January 1, 2006. |
AT |
Acute treatment (chiropractic claims) - This modifier
should be used when reporting CPT codes 98940, 98941, 98942 or
98943 for acute treatment. No effect on payment. |
CC |
Procedure code change- CARRIER USE ONLY - Used by
carrier to indicate that the procedure code submitted was changed
either for administrative reasons or because an incorrect code was
filed. No effect on payment. Payment determination will be based
on the "new" code used by the carrier. |
CR
|
Catastrophe/disaster related. It is required when an
item or service is impacted by an emergency or disaster and
Medicare payment for such item or service is conditioned on the
presence of a “formal waiver”. |
EA |
Erythropoetic stimulating agent (ESA) administered to
treat anemia due to anti-cancer chemotherapy |
EB |
Erythropoetic stimulating agent (ESA) administered to
treat anemia due to anti-cancer radiotherapy |
EC |
Erythropoetic stimulating agent (ESA) administered to
treat anemia not due to anti-cancer radiotherapy or anti-cancer
chemotherapy |
EJ |
Subsequent claims for a defined course of therapy, e.g., EPO,
sodium hyaluronate, infliximab. |
ET |
Emergency treatment - Use to designate a dental
procedure performed in an emergency situation. No effect on
payment. |
FB |
Item provided without cost to provider, supplier or
practitioner, or credit received for replaced device (examples,
but not limited to covered under warranty, replaced due to defect,
free samples) |
GA |
Waiver of liability statement on file - Use to indicate
that the physician's office has a signed advance notice retained
in the patient's medical record. The notice is for services that
may be denied by Medicare. No effect on payment; however,
potential liability determinations are based in part on the use of
modifier. Updated description effective April 1, 2010: Waiver of
Liability Statement Issued, as Required by Payer Policy. This
modifier should be used to report when a required ABN was issued
for a service. |
GJ |
Opted Out physician or practitioner - Use to indicate
services performed in an emergency or urgent service. |
GS |
Dosage of EPO or Darbepoietin Alfa has been reduced and
maintained in response to hematocrit or hemoglobin level. |
GV |
Attending physician not employed or paid under agreement by the
patient's hospice provider. |
GW |
Service not related to the hospice patient's terminal
condition. |
GX |
Notice of Liability Issued, Voluntary Under Payer Policy. This
modifier should be used to report when a voluntary ABN was issued
for a service.
|
GY |
Use to indicate when an item or service statutorily excluded or
does not meet the definition of any Medicare benefit. |
GZ |
Use to indicate when an item or service expected to be denied
as not reasonable and necessary. Used when no Advanced Beneficiary
Notice (ABN) signed by the beneficiary.) |
G7 |
Pregnancy resulted from rape or incest or pregnancy certified
by physician as life threatening |
JA |
Administered intravenously |
JB |
Administered subcutaneously |
KB |
Beneficiary requested upgrade for ABN, more than 4 modifiers
identified on claim |
KD |
Drug or biological infused through DME. |
KX |
Updated description effective April 1, 2010: Requirements
specified in the medical policy have been met. May be used when a
therapy exception is appropriate or should be billed with any
procedure code(s) that are gender specific for the affected
beneficiaries.
|
KM |
Replacement of facial prosthesis - including new
impression/moulage |
KN |
Replacement of facial prosthesis - Using previous master
model |
KZ |
New Coverage not implemented by managed care |
M2 |
Medicare Secondary Payer |
QC |
Single channel monitoring - No effect on payment. |
QD |
Recording and storage in solid state memory by a digital
recorder - No effect on payment. |
QJ |
Services/items provided to a prisoner or patient in state or
local custody, however the State or Local government, as
applicable, meets the requirements in 42 CFR 411.4(B) |
QT |
Recording and storage on tape by an analog tape recorder -
No effect on payment. |
Q3 |
Liver Kidney Donor Surgery and Related Services - No
effect on payment. |
Q4 |
Service for ordering/referring physician qualifies as a
service exemption - No effect on payment. |
Q5 |
Service furnished by a substitute physician under a
reciprocal billing arrangement - No effect on payment. |
Q6 |
Service furnished by a locum tenens physician - No
effect on payment. |
SK |
Member of high risk population (Use only with codes for
immunization) |
32 |
Mandated services - Services related to mandated
consultations and/or related services (e.g., PRO, third party
payer, governmental, legislative or regulatory requirement) may be
identified by adding the modifier '-32' to the base procedure. |
59 |
Distinct Procedural Service - Under certain
circumstances, the physician may need to indicate that a procedure
or service was distinct or independent from other services
performed on the same day. Modifier '-59' is used to identify
procedures/services that are not normally reported together, but
are appropriate under the circumstances. This may represent a
different session or patient encounter, different procedure or
surgery, different site or organ system, separate
incision/excision, separate lesion, or separate injury (or area of
injury in extensive injuries) not ordinarily encountered or
performed on the same day by the same physician. However, when
another already established modifier is appropriate it should be
used rather than modifier '-59' only if no more descriptive
modifier is available, and the use of modifier '-59' best explains
the circumstances, should modifier '-59' be used. Correct Coding Initiative (CCI) Modifier: Modifier 59 does not replace modifiers 24, 25, 50, 51, 78 ,79, RT and LT Modifier 59 is not used on Evaluation and Management CPT codes. |
99 |
Multiple modifiers- Use only when more than four
modifiers are needed to describe a service. The additional
modifiers should be included with the claim (item 19 on paper
submissions, or appropriate message or freeform area on electronic
submissions).No effect on payment; however, the individual
modifiers listed will apply, including any potential effect they
may on payment. |
Out-patient Hospital/Ambulatory Surgical Center (ASC)
73 |
Discontinued out-patient hospital or ambulatory surgical
center (ASC) procedure prior to the administration of anesthesia -
Due to extenuating circumstances or those that threaten the well
being of the patient, the physician may cancel a surgical or
diagnostic procedure subsequent to the patient's surgical
preparation (including sedation when provided, and being taken to
the room where the procedure is to be performed), but prior to the
administration of anesthesia (local, regional block(s), or
general). Under these circumstances, the intended service that is
prepared for but canceled can be reported by its usual procedure
number and the addition of the modifier -73 or by use of the
separate five digit modifier code 09973. Note: the elective
cancellation of a service prior to the administration of
anesthesia and/or surgical preparation of the patient should not
be reported. For physician reporting of a discontinued procedure,
see modifier -53. |
SG
|
Ambulatory Surgical Center (ASC) modifier - This
modifier identifies those services performed in the ASC facility
that will generate a facility fee allowance. This modifier is NOT
used by the performing physician/surgeon. Beginning January 1,
2008, ASCs no longer are required to include the SG modifier on
facility claims to Medicare. |
74
|
Discontinued out-patient hospital/ambulatory surgery center
(ASC) procedure after administration of anesthesia - Due to
extenuating circumstances or those that threaten the well being of
the patient, the physician may terminate a surgical or diagnostic
procedure after the administration of anesthesia (local, regional
block(s), general) or after the procedure was started (incision
made, intubation started, scope inserted, etc). Under these
circumstances, the procedure started but terminated can be
reported by its usual procedure number and the addition of the
modifier -74 or by use of the separate five-digit modifier code
09974.Note: the elective cancellation of a service prior to the
administration of anesthesia and/or surgical preparation of the
patient should not be reported for physician reporting of a
discontinued procedure, see modifier -53. |
Physical Therapist
GP |
Services delivered under an outpatient physical therapy plan of
care. |
Performance Measure Exclusion Modifiers indicate that an action specified in the measure was not provided due to medical, patient, or system reason(s) documented in the medical record. Performance measure exclusion modifiers fall into one of three categories:
1P |
Performance Measure Exclusion Modifier due to Medical
Reasons: Includes: Not Indicated (absence of organ/limb, already received/performed, other); Contraindicated (patient allergic history, potential adverse drug interaction, other) |
2P |
Performance Measure Exclusion Modifier due to Patient
Reasons: Includes: patient declined; economic, social, or religious reasons; other patient reasons |
3P |
Performance Measure Exclusion Modifier due to System Reasons
includes: Resources to perform the services not available; insurance coverage/payor-related limitations; other reasons attributable to health care delivery system. Performance Measure Reporting Modifier: Facilitates reporting a case when the patient is eligible but an action described in a measure is not performed and the reason is not specified or documented. |
8P |
Performance Measure Reporting Modifier- Action not
performed, reason not otherwise specified |
Positron Emission Tomography (PET)
PI |
Positron Emission Tomography (PET) or PET/Computed Tomography
(CT) to inform the initial treatment strategy of tumors that are
biopsy proven or strongly suspected of being cancerous based on
other diagnostic testing. |
PS |
Positron Emission Tomography (PET) or PET/Computed Tomography
(CT) to inform the subsequent treatment strategy of cancerous
tumors when the beneficiary's treating physician determines that
the PET study is needed to inform subsequent anti-tumor strategy. |
Speech-Language Pathologist
GN |
Services delivered under an outpatient speech language
pathology plan of care. |
Surgical Procedure Expanded Modifiers: Hands-Feet-Eyelids
The following modifiers should be used in conjunction with procedures of the hands, feet and eyelids. The modifiers will not affect the payment amount; however, failure to use these modifiers when appropriate could result in claim delay or denial.
E1 |
Upper left, eyelid
|
E3 |
Upper right, eyelid |
E2 |
Lower left, eyelid
|
E4 |
Lower right, eyelid |
FA |
Left hand, thumb
|
F5 |
Right hand, thumb |
F1 |
Left hand, second digit
|
F6 |
Right hand, second digit |
F2 |
Left hand, third digit
|
F7 |
Right hand, third digit |
F3 |
Left hand, fourth digit
|
F8 |
Right hand, fourth digit |
F4 |
Left hand, fifth digit
|
F9 |
Right hand, fifth digit |
TA |
Left foot, great toe
|
T5 |
Right foot, great toe |
T1 |
Left foot, second digit
|
T6 |
Right foot, second digit |
T2 |
Left foot, third digit
|
T7 |
Right foot, third digit |
T3 |
Left foot, fourth digit
|
T8 |
Right foot, fourth digit |
T4 |
Left foot, fifth digit
|
T9 |
Right foot, fifth digit |
Surgical Procedure Modifiers
LT |
Left Side - Used to identify procedures performed on the
left side of the body. No effect on payment; however, failure to
use when appropriate could result in delay or denial (or partial
denial) of the claim.
|
PA |
Surgical or other invasive procedure on wrong body part |
PB |
Surgical or other invasive procedure on wrong patient |
PC |
Wrong surgery or other invasive procedure on patient |
RT |
Right Side - Used to identify procedures performed on
the right side of the body. No effect on payment; however, failure
to use when appropriate could result in delay or denial (or
partial denial) of the claim.
|
22 |
Unusual procedural services - Used on surgery codes. An
operative note should be submitted with the claim. May result in
increased payment. DOCUMENTATION must be submitted. |
50 |
Bilateral procedure - Unless otherwise identified in the
listings, bilateral procedures that are performed at the same
operative session should be identified by adding the modifier -50
to the appropriate five digit code. |
51 |
Multiple procedures - When multiple procedures, other
than evaluation and management services, are performed on the same
day or at the same session by the same provider, the primary
procedure or service may be reported as listed. The additional
procedure(s) or service(s) may be identified by adding modifier
'-51' to the additional procedure or service code(s). MODIFIER
51 IS NOT REQUIRED FOR BILLING PURPOSES: The carrier will
assign the multiple procedure modifier if appropriate based on the
services billed. PAYMENT RULES: We approve 100% of the fee schedule amount for the highest valued procedure, 50% for the 2nd-5th procedures and "by report" for subsequent procedures. Payment determined on a “by report” basis for these codes should never be lower than 50 percent of the full payment amount. EXCEPTIONS: Multiple endoscopies: Special rules for multiple endoscopic procedures apply if the procedure is billed with another endoscopy in the same family. See CMS Internet Only Manual, Pub. 100-04, Chapter 12, Section 40.6 for endoscopy rules. |
52 |
Reduced services - Under certain circumstances a service
or procedure is partially reduced or eliminated at the physician's
discretion. Under these circumstances the service provided can be
identified by its usual procedure number and the addition of the
modifier -52, signifying that the service is reduced. This
provides a means of reporting reduced services without disturbing
the identification of the basic service. Note: For hospital
out-patient reporting of a previously scheduled procedure or
service that is partially reduced or canceled as a result of
extenuating circumstances or those that threaten the well-being of
a patient prior to or after administration of anesthesia, see
modifiers -73 and -74 (these modifiers are approved for ASC
hospital out-patient use). |
53 |
Discontinued procedure - Under certain circumstances,
the physician may elect to terminate a surgical or diagnostic
procedure. Due to extenuating circumstances or those that threaten
the well being of the patient, it may be necessary to indicate
that a surgical or diagnostic procedure was started but
discontinued. This circumstance may be reported by adding the
modifier '-53' to the code reported by the physician for the
discontinued procedure. Note: This modifier is not used to report
the elective cancellation of a procedure prior to the patient's
anesthesia induction and/or surgical preparation in the operating
suite. For outpatient hospital/ambulatory surgery center (ASC)
reporting of a previously scheduled procedure/service that is
partially reduced or canceled as a result of extenuating
circumstances or those that threaten the well-being of the patient
prior to or after administration of anesthesia, see modifiers -73
and -74 (modifiers approved for ASC and hospital out-patient use). |
54 |
Surgical care only- Use with surgical codes when only
the surgical service was performed. Payment will be limited to the
amount allotted to the preoperative and intraoperative services
only. |
55 |
Postoperative care only - Use with surgical codes only
to indicate that only the postoperative care was performed
(another physician performed the surgery). Payment will be limited
to the amount allotted for postoperative services only. |
58 |
Staged or related procedure or service during the
postoperative period- This modifier should be used to permit
payment for a surgical procedure during the postoperative period
of another surgical procedure when (1) the subsequent procedure
was planned prospectively at the time of the original procedure,
(2) a less extensive procedure fails and a more extensive
procedure is required or (3) a therapeutic surgical procedure
follows a diagnostic procedure e.g., a mastectomy follows a breast
biopsy. Failure to use modifier when appropriate may result in
denial of the subsequent surgery. |
62 |
Two surgeons - When two surgeons work together as
primary surgeons performing distinct part(s) of a single
reportable procedure, each surgeon should report his/her distinct
operative work by adding the modifier -62 to the single distinct
procedure code. Each surgeon should report the co-surgery once
using the same procedure code. If additional procedure(s)
(including add-on procedures) are performed during the same
surgical session, separate codes may be reported without the
modifier -62 added. Note: If a co-surgeon acts as an assistant in
the performance of additional procedure(s) during the same
surgical session, those services may be reported using separate
procedure code(s), with modifier -80 or modifier -81 added, as
appropriate. |
66 |
Surgical team - The modifier should be used by each
participating surgeon to report his services. When team surgery is
medically necessary, the carrier will determine the appropriate
allowances(s) "by report." |
76 |
Repeat procedure by same physician - The physician may
need to indicate that a procedure or service was repeated
subsequent to the original procedure or service. This circumstance
may be reported by adding modifier -76 to the repeated procedure
or service. |
77 |
Repeat procedure by another physician - The physician
may need to indicate that a basic procedure or service performed
by another physician had to be repeated. This situation may be
reported by adding modifier -77 to the repeated procedure or
service. |
78 |
Return to OR for related surgery during postop period -
Use on surgical codes only to indicate that another procedure was
performed during the postoperative period of the initial
procedure, was related to the first, and required the use of the
operating room. Payment is limited to the amount allotted for
intraoperative services only. Failure to use this modifier when
appropriate may result in denial of the subsequent surgery. |
79 |
Unrelated surgery during postop period - Use on surgical
codes only to indicate that the performance of a procedure during
the postoperative period of another surgery was unrelated to the
original procedure. Failure to use this modifier when appropriate
may result in denial of the subsequent surgery. |
80 |
Assistant surgeon - Reimburses the assistant surgeon at
16% of the Medicare Physician Fee Schedule Data Base allowance for
the surgical procedure. |
Teaching Physician
GC |
This service has been performed in part by a resident under the
direction of a teaching physician. |
GE |
This service has been performed by a resident without the
presence of a teaching physician under the primary care exception. |
Teleconsultations
GQ |
Via asynchronous telecommunications system |
GT |
Via interactive audio and video telecommunication systems |
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