Question

CPT codes have a number of modifiers.

Define CPT modifiers.

Explain how the ranking of modifiers is done.

Give examples of CPT modifiers.

Answer 1

Modifiers provide a way in which providers can indicate in what way a procedure or service is changed due to circumstances and not affect the actual procedure or code. CPT modifiers are additions to CPT code which gives extra information about how, where and why a procedure was done.

RANKING OF MODIFIERS:

• When entering only one modifier, enter it in the first modifier field.
• When entering a pricing modifier, enter it in the first modifier field only.
• When entering the pricing modifier and statistical modifier that affects pricing modifier, enter the pricing modifier in first field and statistical modifier in second field.
• When entering statistical modifier that affects pricing and statistical/informational modifier, enter the statistical modifier in the first field.
• When entering more than one statistical/informational modifier with no modifier that affects pricing, it doesn't matter in which is entered in first field. Exception is for QT, QW,SF modifiers which should be entered only in first field.
• When more than 4 modifiers apply, enter modifier 99 in first field

EXAMPLES OF CPT MODIFIERS

• -53 (discontinued procedure)
• -59 (distinct procedural service)
• -79 (unrelated procedure or service performed by the same physician during postoperative procedure)