SURGICAL PROCEDURE MODIFIERS

LC - Left circumflex coronary artery
LD - Left anterior descending coronary artery
LS - FDA monitored Intraocular Lens Implant
LT -Left side - Used to identify procedures performed on the left side of the body
RC - Right Coronary Artery
RT - Right side - Used to identify procedures performed on the right side of the body
22 - Unusual procedural services - Used only on surgery codes. An operative note should be submitted with the claim
50 - Bilateral procedure - Used to indicate bilateral procedures performed during the same operative session. The code with modifier 50 should be billed only once on the claim.
51 - Multiple procedures - not required for billing purposes. The carrier will assign the multiple procedure modifier as appropriate based on the services billed.
52 - Reduced Services - Use for reporting services that were partially reduced or eliminated at the physician’s election. Documentation should be furnished explaining the reduction.
53 - Terminated procedure without complications- for procedures terminated in respect to the patients condition
54 - Surgical care only - Use with surgical codes when only the surgical service was performed (another physician is responsible for the pre- and/or postoperative management).
55 - Post-operative care only - Use with surgical codes to indicate that only the post-operative care is performed (another physician performed the surgery)
56 - Pre-operative care only - DO NOT USE FOR MEDICARE PURPOSES
- Payment for this component is included in the allowable for surgery. If another physician performed the surgery, use an appropriate E/M code to bill the pre-op service.
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 subsequent surgery
59 - Distinct Procedural Service - Use under certain circumstances where the physician may need to indicate that a procedure is distinct or independent from others services performed on the same day, same provider and are not normally reported together but are appropriate under the circumstances.
62 - Two surgeons - When more than one surgeon performed a procedure, the modifier should be used by each surgeon to report his/her services.
66 - Surgical team - The modifier should be used by each participating surgeon to report his services.
76 - Repeat procedure by same physician -same day
77 - Repeat procedure - same day, different physician
78 - Return to the operating room for a related procedure during the postoperative period - Use on surgical codes only.
- Failure to use modifier when appropriate may result in denial of the subsequent surgery
79 - Return to the operating room for an unrelated procedure during the postoperative period - Use on surgical codes only.
80 - Assistant surgeon
81 - Minimum assistant surgeon
82 - Assistant surgeon (when qualified resident surgeon not available)

ASC modifiers
Medical billing modifier AI
Evaluation management code modifiers
CPT code modifiers
Diagnostic procedure modifiers

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