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Modifiers

The document outlines various medical modifiers used for billing and coding in healthcare. Each modifier serves a specific purpose, such as indicating unrelated diagnoses, repeat procedures, or anesthesia administration. Key modifiers include 24 for unrelated E&M services, 25 for E&M on the same day as another service, and 76 for repeat procedures by the same physician.

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1 views2 pages

Modifiers

The document outlines various medical modifiers used for billing and coding in healthcare. Each modifier serves a specific purpose, such as indicating unrelated diagnoses, repeat procedures, or anesthesia administration. Key modifiers include 24 for unrelated E&M services, 25 for E&M on the same day as another service, and 76 for repeat procedures by the same physician.

Uploaded by

afnanfathima1127
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

MODIFIERS

Modifier 24 is used for E&M servies when DX is unreleated to surgery.

Modifier 25 description:- used to report an Evaluation and Management (E/M)


service on a day when another service was provided to the patient by the same
physician or other qualified health care professional.

Modifer 26 Professional services:- It is most commonly submitted with diagnostic


tests, including radiology, xrays and other high energy radiations.

modifier 52:- is reportable if no anesthesia was administered and the


physician elected to terminate the procedure.

modifier 53 would be applicable if anesthesia was administered and the


procedure was terminated due to extenuating circumstances

Modifier 59:- Separate procedural services:- Under certain situations the physician
may ned to indicate that the procedure or services were separate from other
services performed on the same day,

Modifier 47:- Anesthesia by surgeon.

Modifier 76:- Modifier 76 is defined as a repeat procedure or service by the same


physician or other qualified healthcare professional. Used to indicate a procedure or
service was repeated by the same physician or other qualified healthcare
professional subsequent to the original procedure or service.

Modifier 77:- IS used to report a repeat procedure by another physician and is


appended to the repeat procedure to report the same service provided by another
physician.

Modifier 79 is used for other than E&M serviceswhen DX is unreleatd to surgery.

MODIFIER 58 Submit CPT modifier 58 to indicate that the performance of a


procedure or service during the postoperative period was either: Planned
prospectively at the time of the original procedure (staged); More extensive
than the original procedure; or. For the therapy following a surgical procedure.

MODIFIER 78 :- is used to report an unplanned return to the operating or


procedure room, by the same physician, following an initial procedure
for a related procedure during the post-operative period

Modifier 54:- Surgical Care Only.

MODIFIER 92:- Alternative Laboratory Platform Testing.


Modifier 91:- is used when a clinical laboratory test must be repeated on
the same date of service and the results are used to assist in managing
the treatment of a patient..

Modifier 27- as “multiple outpatient hospital evaluation and


management encounters on the same date.”

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