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CPT
modifiers
Term | Definition |
---|---|
22 Increased Procedural Services | when services provided is greater than that usually required for the listed procedure |
23 Unusual Anesthesia | when a procedure usually requires either no anesthesia or local anesthesia |
24 Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Healthcare Professional during a Postoperative Period | the physician or other qualified professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason unrelated to the original procedure |
25 Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Healthcare Professional on the Same day of the Procedure or Other Service | the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided |
26 Professional Component | certain procedures are a combination of a physician or other qualified healthcare professional and a technical component |
32 Mandated Services | services related to mandated consultation and /or related services |
47 Anesthesia by Surgeon | surgeon or general anesthesia provide by the surgeon may be reported by adding modifier 47 to the basic service |
50 Bilateral Procedure | bilateral procedures that are performed at the same operative session |
51 Multiple Procedures | when multiple procedures, other than E/M services, Physical Medicine and Rehabilitation services or provision of supplies are performed at the same session by the same provider |
52 Reduced Services | a service or procedure is partially reduced or eliminated at the physician's or other qualified healthcare professionals' discretion |
53 Discontinued Procedure | the physician or other qualified healthcare professional may elect to terminate a surgical or diagnostic procedure |
54 Surgical Care Only | when one physician or other qualified healthcare professional performs a surgical procedure and another provides preoperative and/or postoperative management |
55 Postoperative Management Only | when one physician or other qualified healthcare professional performs the postoperative management and another performed the surgical procedure |
56 Preoperative Management Only | when one physician or other qualified healthcare professional performs the preoperative care and evaluation and another physician performs the surgical procedure |
57 Decision for Surgery | an evaluation and management that resulted in the initial decision to perform the surgery |
58 Staged or Related Procedure or Service by the Same Physician or Other Qualified Healthcare Professional During Postoperative Period | to indicate a procedure or service during the postoperative period was; a) planned prospectively at the time of the original procedure (staged); b) more extensive than the original procedure; or c) for therapy following a diagnostic surgical procedure |
59 Distinct Procedural Service | to indicate that a procedure or service as distinct or independent from other non-E/M services performed that same day |
62 Two Surgeons | when two surgeons work together as primary surgeons preforming distinct parts of a procedure |
63 Procedure Performed on Infants less than 4 kg | procedures performed on neonates and infants, up to a present body weight of 4kg, many involve significantly increase complexity and physician or other qualified healthcare professional work commonly associated with these patients |
66 Surgical Team | highly complex procedures are carried out under the surgical them concept |
76 Repeat Procedure or Service by Same Physician or Other Qualified Healthcare Professional | the physician or other qualified healthcare professional may need to indicate that a procedure or service was repeated |
77 Repeat Procedure by Another Physician or Other Qualified Healthcare Professional | to indicate that a procedure or service performed by another physician or other qualified healthcare professional was repeated |
78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Healthcare Professional Following Initial Procedure for a Related Procedure during the Postoperative Period | to indicate another procedure was performed during the postoperative period of the initial procedure |
79 Unrelated Procedure or Service by the Same Physician or Other Qualified Healthcare Professional During the Postoperative Period | the physician or other qualified healthcare professional many need ton indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure |
80 Assistant Surgeon | surgical surgeon assistant services may be identified |
81 Minimum Assistant Surgeon | minimum assistant surgeon is called to assist for a limited period of time |
82 Assistant Surgeon (when qualified resident surgeon not available) | the unavailability of a qualified resident surgeon is a prerequisite for use |
90 Reference (Outside) Laboratory | when a laboratory procedures are performed by a party other than the treating or reporting physician or other qualified healthcare professional |
91 Repeat Clinical Diagnostic Laboratory Test | when it may be necessary to repeat the same laboratory test on the same day to obtain subsequent test result |
92 Alternative Laboratory Platform Testing | when laboratory testing is being performed using a kit or transportable instrument that wholly or in part consists f a single use, disposable analytical chamber |
95 Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System | codes that have a star symbol when electronic communication is performed using real-time interactive audio and video communications system |
99 Multiple Modifiers | two or more modifiers may be necessary to delineate completely a service and other applicable modifiers may be listed as part of the service description |