Modifier Code in Medical Billing

Roles of Modifier

Modifiers are codes that are used to “ENHANCE OR ALTER THE DESCRIPTION OF A SERVICE OR SUPPLY” UNDER CERTAIN CIRCUMSTANCES. A modifier provides the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code. The judicious application of modifiers obviates the necessity for separate procedure listings that may describe the modifying circumstance.

Modifiers may be used under the following circumstances:-

· A service or procedure has both a professional and technical component.
· A service or procedure was performed by more than one physician and/or in more than one location.
· A service or procedure has been increased or reduced.
· Only part of a service was performed.
· An adjunctive service was performed.
· A bilateral procedure was performed.
· A service or procedure was provided more than once.
· Unusual events occurred.

The following are the most commonly used modifiers:

Professional Component - 26
Technical Component - TC
Bilateral Procedure - 50
Right side of body - RT
Left side of body - LT
Distinct Procedural Service - 59

CPT code Modifiers
CPT modifier
CPT modifiers
ASC modifier SG
CPT modifier 51
CPT modifier 62 and 66
CPT Modifier 22 and 51
CPT modifier 22 and 24
CPT modifier 52 and 53
CPT modifier 26 and TC
CPT modifier 59
CPT anesthesia modifier codes
ASC modifiers
Modifier 59
CPT modifier 25
CPT modifier 24
CPT modifier 57
CPT modifier 78
CPT Modifier 79
Surgical modifiers
CPT modifier 58

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