LINUXFORHEALTH.FHIR.IG\Procedure Modifier Codes - XML Representation

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: Procedure Modifier Codes - XML Representation

Active as of 2022-11-10


<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="procedure-modifier"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This code system <code>http://linuxforhealth.org/fhir/cdm/CodeSystem/procedure-modifier</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">1P<a name="procedure-modifier-1P"> </a></td><td>PM excl-med reasons</td><td>Performance measure exclusion-medical reasons</td></tr><tr><td style="white-space:nowrap">2P<a name="procedure-modifier-2P"> </a></td><td>PM excl-pt reasons</td><td>Performance measure exclusion-patient reasons</td></tr><tr><td style="white-space:nowrap">3P<a name="procedure-modifier-3P"> </a></td><td>PM excl-system reason</td><td>Performance measure exclusion-system reasons</td></tr><tr><td style="white-space:nowrap">A1<a name="procedure-modifier-A1"> </a></td><td>Dressing for one wound</td><td/></tr><tr><td style="white-space:nowrap">A2<a name="procedure-modifier-A2"> </a></td><td>Dressing for two wounds</td><td/></tr><tr><td style="white-space:nowrap">A3<a name="procedure-modifier-A3"> </a></td><td>Dressing for three wounds</td><td/></tr><tr><td style="white-space:nowrap">A4<a name="procedure-modifier-A4"> </a></td><td>Dressing for four wounds</td><td/></tr><tr><td style="white-space:nowrap">A5<a name="procedure-modifier-A5"> </a></td><td>Dressing for five wounds</td><td/></tr><tr><td style="white-space:nowrap">A6<a name="procedure-modifier-A6"> </a></td><td>Dressing for six wounds</td><td/></tr><tr><td style="white-space:nowrap">A7<a name="procedure-modifier-A7"> </a></td><td>Dressing for seven wounds</td><td/></tr><tr><td style="white-space:nowrap">A8<a name="procedure-modifier-A8"> </a></td><td>Dressing for eight wounds</td><td/></tr><tr><td style="white-space:nowrap">A9<a name="procedure-modifier-A9"> </a></td><td>Dressing for nine or more wounds</td><td/></tr><tr><td style="white-space:nowrap">AA<a name="procedure-modifier-AA"> </a></td><td>Anesthesia services performed personally by anesthesiologist</td><td/></tr><tr><td style="white-space:nowrap">AD<a name="procedure-modifier-AD"> </a></td><td>Medical supervision by a physician: more than four concurrent anesthesia procedures</td><td/></tr><tr><td style="white-space:nowrap">AE<a name="procedure-modifier-AE"> </a></td><td>Registered dietician</td><td/></tr><tr><td style="white-space:nowrap">AF<a name="procedure-modifier-AF"> </a></td><td>Specialty physician</td><td/></tr><tr><td style="white-space:nowrap">AG<a name="procedure-modifier-AG"> </a></td><td>Primary physician</td><td/></tr><tr><td style="white-space:nowrap">AH<a name="procedure-modifier-AH"> </a></td><td>Clinical psychologist</td><td/></tr><tr><td style="white-space:nowrap">AI<a name="procedure-modifier-AI"> </a></td><td>Principal physician of record</td><td/></tr><tr><td style="white-space:nowrap">AJ<a name="procedure-modifier-AJ"> </a></td><td>Clinical social worker</td><td/></tr><tr><td style="white-space:nowrap">AK<a name="procedure-modifier-AK"> </a></td><td>Non participating physician</td><td/></tr><tr><td style="white-space:nowrap">AM<a name="procedure-modifier-AM"> </a></td><td>Physician, team member service</td><td/></tr><tr><td style="white-space:nowrap">AO<a name="procedure-modifier-AO"> </a></td><td>Alternate payment method declined by provider of service</td><td/></tr><tr><td style="white-space:nowrap">AP<a name="procedure-modifier-AP"> </a></td><td>Determination of refractive state was not performed in the course of diagnostic ophthalmological examination</td><td/></tr><tr><td style="white-space:nowrap">AQ<a name="procedure-modifier-AQ"> </a></td><td>Physician providing a service in an unlisted health professional shortage area (hpsa)</td><td/></tr><tr><td style="white-space:nowrap">AR<a name="procedure-modifier-AR"> </a></td><td>Physician provider services in a physician scarcity area</td><td/></tr><tr><td style="white-space:nowrap">AS<a name="procedure-modifier-AS"> </a></td><td>Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery</td><td/></tr><tr><td style="white-space:nowrap">AT<a name="procedure-modifier-AT"> </a></td><td>Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)</td><td/></tr><tr><td style="white-space:nowrap">AU<a name="procedure-modifier-AU"> </a></td><td>Item furnished in conjunction with a urological, ostomy, or tracheostomy supply</td><td/></tr><tr><td style="white-space:nowrap">AV<a name="procedure-modifier-AV"> </a></td><td>Item furnished in conjunction with a prosthetic device, prosthetic or orthotic</td><td/></tr><tr><td style="white-space:nowrap">AW<a name="procedure-modifier-AW"> </a></td><td>Item furnished in conjunction with a surgical dressing</td><td/></tr><tr><td style="white-space:nowrap">AX<a name="procedure-modifier-AX"> </a></td><td>Item furnished in conjunction with dialysis services</td><td/></tr><tr><td style="white-space:nowrap">AY<a name="procedure-modifier-AY"> </a></td><td>Item or service furnished to an esrd patient that is not for the treatment of esrd</td><td/></tr><tr><td style="white-space:nowrap">AZ<a name="procedure-modifier-AZ"> </a></td><td>Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment</td><td/></tr><tr><td style="white-space:nowrap">BA<a name="procedure-modifier-BA"> </a></td><td>Item furnished in conjunction with parenteral enteral nutrition (pen) services</td><td/></tr><tr><td style="white-space:nowrap">BL<a name="procedure-modifier-BL"> </a></td><td>Special acquisition of blood and blood products</td><td/></tr><tr><td style="white-space:nowrap">BO<a name="procedure-modifier-BO"> </a></td><td>Orally administered nutrition, not by feeding tube</td><td/></tr><tr><td style="white-space:nowrap">BP<a name="procedure-modifier-BP"> </a></td><td>The beneficiary has been informed of the purchase and rental options and has elected to purchase the item</td><td/></tr><tr><td style="white-space:nowrap">BR<a name="procedure-modifier-BR"> </a></td><td>The beneficiary has been informed of the purchase and rental options and has elected to rent the item</td><td/></tr><tr><td style="white-space:nowrap">BU<a name="procedure-modifier-BU"> </a></td><td>The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision</td><td/></tr><tr><td style="white-space:nowrap">CA<a name="procedure-modifier-CA"> </a></td><td>Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission</td><td/></tr><tr><td style="white-space:nowrap">CB<a name="procedure-modifier-CB"> </a></td><td>Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable</td><td/></tr><tr><td style="white-space:nowrap">CC<a name="procedure-modifier-CC"> </a></td><td>Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)</td><td/></tr><tr><td style="white-space:nowrap">CD<a name="procedure-modifier-CD"> </a></td><td>Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable</td><td/></tr><tr><td style="white-space:nowrap">CE<a name="procedure-modifier-CE"> </a></td><td>Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal * frequency covered under the rate and is separately reimbursable based on medical necessity</td><td/></tr><tr><td style="white-space:nowrap">CF<a name="procedure-modifier-CF"> </a></td><td>Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable</td><td/></tr><tr><td style="white-space:nowrap">CG<a name="procedure-modifier-CG"> </a></td><td>Policy criteria applied</td><td/></tr><tr><td style="white-space:nowrap">CH<a name="procedure-modifier-CH"> </a></td><td>0 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CI<a name="procedure-modifier-CI"> </a></td><td>At least 1 percent but less than 20 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CJ<a name="procedure-modifier-CJ"> </a></td><td>At least 20 percent but less than 40 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CK<a name="procedure-modifier-CK"> </a></td><td>At least 40 percent but less than 60 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CL<a name="procedure-modifier-CL"> </a></td><td>At least 60 percent but less than 80 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CM<a name="procedure-modifier-CM"> </a></td><td>At least 80 percent but less than 100 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CN<a name="procedure-modifier-CN"> </a></td><td>100 percent impaired, limited or restricted</td><td/></tr><tr><td style="white-space:nowrap">CO<a name="procedure-modifier-CO"> </a></td><td>Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant</td><td/></tr><tr><td style="white-space:nowrap">CP<a name="procedure-modifier-CP"> </a></td><td>Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure, but reported on a different claim</td><td/></tr><tr><td style="white-space:nowrap">CQ<a name="procedure-modifier-CQ"> </a></td><td>Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant</td><td/></tr><tr><td style="white-space:nowrap">CR<a name="procedure-modifier-CR"> </a></td><td>Catastrophe/disaster related</td><td/></tr><tr><td style="white-space:nowrap">CS<a name="procedure-modifier-CS"> </a></td><td>Item or service related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the gulf of mexico, including but not limited to subsequent clean-up activities</td><td/></tr><tr><td style="white-space:nowrap">CT<a name="procedure-modifier-CT"> </a></td><td>Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard</td><td/></tr><tr><td style="white-space:nowrap">DA<a name="procedure-modifier-DA"> </a></td><td>Oral health assessment by a licensed health professional other than a dentist</td><td/></tr><tr><td style="white-space:nowrap">DD<a name="procedure-modifier-DD"> </a></td><td>AMB-site NEC to site NEC</td><td>Ambulance service from diagnostic or therapeutic site other than P or H  to diagnostic or therapeutic site other than P or H</td></tr><tr><td style="white-space:nowrap">DE<a name="procedure-modifier-DE"> </a></td><td>AMB-site NEC to RES fac</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to residential</td></tr><tr><td style="white-space:nowrap">DG<a name="procedure-modifier-DG"> </a></td><td>AMB-site NEC-hosp ESRD</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to hospital-based ESRD facility</td></tr><tr><td style="white-space:nowrap">DH<a name="procedure-modifier-DH"> </a></td><td>AMB-site NEC to hosp</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to hospital</td></tr><tr><td style="white-space:nowrap">DI<a name="procedure-modifier-DI"> </a></td><td>AMB-site NEC-transf site</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to site of transfer</td></tr><tr><td style="white-space:nowrap">DJ<a name="procedure-modifier-DJ"> </a></td><td>AMB-NEC-Free stand ESRD</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to free standing ESRD facility</td></tr><tr><td style="white-space:nowrap">DN<a name="procedure-modifier-DN"> </a></td><td>AMB-site NEC to SNF</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to skilled nursing facility (SNF)</td></tr><tr><td style="white-space:nowrap">DP<a name="procedure-modifier-DP"> </a></td><td>AMB-site NEC to OV</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to physician's office</td></tr><tr><td style="white-space:nowrap">DR<a name="procedure-modifier-DR"> </a></td><td>AMB-site NEC to home</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to residence</td></tr><tr><td style="white-space:nowrap">DS<a name="procedure-modifier-DS"> </a></td><td>AMB-site NEC to accident</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to scene of accident or acute event</td></tr><tr><td style="white-space:nowrap">DX<a name="procedure-modifier-DX"> </a></td><td>AMB-site NEC to hosp+OV</td><td>Ambulance service from diagnostic or therapeutic site other than P or H to hospital with intermediate stop at physician's office</td></tr><tr><td style="white-space:nowrap">E1<a name="procedure-modifier-E1"> </a></td><td>Upper left, eyelid</td><td/></tr><tr><td style="white-space:nowrap">E2<a name="procedure-modifier-E2"> </a></td><td>Lower left, eyelid</td><td/></tr><tr><td style="white-space:nowrap">E3<a name="procedure-modifier-E3"> </a></td><td>Upper right, eyelid</td><td/></tr><tr><td style="white-space:nowrap">E4<a name="procedure-modifier-E4"> </a></td><td>Lower right, eyelid</td><td/></tr><tr><td style="white-space:nowrap">EA<a name="procedure-modifier-EA"> </a></td><td>Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy</td><td/></tr><tr><td style="white-space:nowrap">EB<a name="procedure-modifier-EB"> </a></td><td>Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy</td><td/></tr><tr><td style="white-space:nowrap">EC<a name="procedure-modifier-EC"> </a></td><td>Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy</td><td/></tr><tr><td style="white-space:nowrap">ED<a name="procedure-modifier-ED"> </a></td><td>Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle</td><td/></tr><tr><td style="white-space:nowrap">EE<a name="procedure-modifier-EE"> </a></td><td>Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle</td><td/></tr><tr><td style="white-space:nowrap">EG<a name="procedure-modifier-EG"> </a></td><td>AMB-RES fac-hosp ESRD</td><td>Ambulance from RES facility to hosp-based ESRD facility</td></tr><tr><td style="white-space:nowrap">EH<a name="procedure-modifier-EH"> </a></td><td>AMB-RES facility to hosp</td><td>Ambulance from residential facility to hospital</td></tr><tr><td style="white-space:nowrap">EI<a name="procedure-modifier-EI"> </a></td><td>AMB-RES fac-transf site</td><td>Ambulance from residential fac to AMB mode transf site</td></tr><tr><td style="white-space:nowrap">EJ<a name="procedure-modifier-EJ"> </a></td><td>Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab</td><td/></tr><tr><td style="white-space:nowrap">EM<a name="procedure-modifier-EM"> </a></td><td>Emergency reserve supply (for esrd benefit only)</td><td/></tr><tr><td style="white-space:nowrap">EN<a name="procedure-modifier-EN"> </a></td><td>AMB-RES facility to SNF</td><td>Ambulance service from residential</td></tr><tr><td style="white-space:nowrap">EP<a name="procedure-modifier-EP"> </a></td><td>Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program</td><td/></tr><tr><td style="white-space:nowrap">ER<a name="procedure-modifier-ER"> </a></td><td>Items and services furnished by a provider-based, off-campus emergency department</td><td/></tr><tr><td style="white-space:nowrap">ES<a name="procedure-modifier-ES"> </a></td><td>AMB-RES fac to accident</td><td>Ambulance from residential facility to accident scene</td></tr><tr><td style="white-space:nowrap">ET<a name="procedure-modifier-ET"> </a></td><td>Emergency services</td><td/></tr><tr><td style="white-space:nowrap">EX<a name="procedure-modifier-EX"> </a></td><td>Expatriate beneficiary</td><td/></tr><tr><td style="white-space:nowrap">EY<a name="procedure-modifier-EY"> </a></td><td>No physician or other licensed health care provider order for this item or service</td><td/></tr><tr><td style="white-space:nowrap">F1<a name="procedure-modifier-F1"> </a></td><td>Left hand, second digit</td><td/></tr><tr><td style="white-space:nowrap">F2<a name="procedure-modifier-F2"> </a></td><td>Left hand, third digit</td><td/></tr><tr><td style="white-space:nowrap">F3<a name="procedure-modifier-F3"> </a></td><td>Left hand, fourth digit</td><td/></tr><tr><td style="white-space:nowrap">F4<a name="procedure-modifier-F4"> </a></td><td>Left hand, fifth digit</td><td/></tr><tr><td style="white-space:nowrap">F5<a name="procedure-modifier-F5"> </a></td><td>Right hand, thumb</td><td/></tr><tr><td style="white-space:nowrap">F6<a name="procedure-modifier-F6"> </a></td><td>Right hand, second digit</td><td/></tr><tr><td style="white-space:nowrap">F7<a name="procedure-modifier-F7"> </a></td><td>Right hand, third digit</td><td/></tr><tr><td style="white-space:nowrap">F8<a name="procedure-modifier-F8"> </a></td><td>Right hand, fourth digit</td><td/></tr><tr><td style="white-space:nowrap">F9<a name="procedure-modifier-F9"> </a></td><td>Right hand, fifth digit</td><td/></tr><tr><td style="white-space:nowrap">FA<a name="procedure-modifier-FA"> </a></td><td>Left hand, thumb</td><td/></tr><tr><td style="white-space:nowrap">FB<a name="procedure-modifier-FB"> </a></td><td>Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)</td><td/></tr><tr><td style="white-space:nowrap">FC<a name="procedure-modifier-FC"> </a></td><td>Partial credit received for replaced device</td><td/></tr><tr><td style="white-space:nowrap">FP<a name="procedure-modifier-FP"> </a></td><td>Service provided as part of family planning program</td><td/></tr><tr><td style="white-space:nowrap">FX<a name="procedure-modifier-FX"> </a></td><td>X-ray taken using film</td><td/></tr><tr><td style="white-space:nowrap">FY<a name="procedure-modifier-FY"> </a></td><td>X-ray taken using computed radiography technology/cassette-based imaging</td><td/></tr><tr><td style="white-space:nowrap">G0<a name="procedure-modifier-G0"> </a></td><td>Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke</td><td/></tr><tr><td style="white-space:nowrap">G1<a name="procedure-modifier-G1"> </a></td><td>Most recent urr reading of less than 60</td><td/></tr><tr><td style="white-space:nowrap">G2<a name="procedure-modifier-G2"> </a></td><td>Most recent urr reading of 60 to 64.9</td><td/></tr><tr><td style="white-space:nowrap">G3<a name="procedure-modifier-G3"> </a></td><td>Most recent urr reading of 65 to 69.9</td><td/></tr><tr><td style="white-space:nowrap">G4<a name="procedure-modifier-G4"> </a></td><td>Most recent urr reading of 70 to 74.9</td><td/></tr><tr><td style="white-space:nowrap">G5<a name="procedure-modifier-G5"> </a></td><td>Most recent urr reading of 75 or greater</td><td/></tr><tr><td style="white-space:nowrap">G6<a name="procedure-modifier-G6"> </a></td><td>Esrd patient for whom less than six dialysis sessions have been provided in a month</td><td/></tr><tr><td style="white-space:nowrap">G7<a name="procedure-modifier-G7"> </a></td><td>Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening</td><td/></tr><tr><td style="white-space:nowrap">G8<a name="procedure-modifier-G8"> </a></td><td>Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure</td><td/></tr><tr><td style="white-space:nowrap">G9<a name="procedure-modifier-G9"> </a></td><td>Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition</td><td/></tr><tr><td style="white-space:nowrap">GA<a name="procedure-modifier-GA"> </a></td><td>Waiver of liability statement issued as required by payer policy, individual case</td><td/></tr><tr><td style="white-space:nowrap">GB<a name="procedure-modifier-GB"> </a></td><td>Claim being re-submitted for payment because it is no longer covered under a global payment demonstration</td><td/></tr><tr><td style="white-space:nowrap">GC<a name="procedure-modifier-GC"> </a></td><td>This service has been performed in part by a resident under the direction of a teaching physician</td><td/></tr><tr><td style="white-space:nowrap">GD<a name="procedure-modifier-GD"> </a></td><td>Units of service exceeds medically unlikely edit value and represents reasonable and necessary services</td><td/></tr><tr><td style="white-space:nowrap">GE<a name="procedure-modifier-GE"> </a></td><td>This service has been performed by a resident without the presence of a teaching physician under the primary care exception</td><td/></tr><tr><td style="white-space:nowrap">GF<a name="procedure-modifier-GF"> </a></td><td>Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital</td><td/></tr><tr><td style="white-space:nowrap">GG<a name="procedure-modifier-GG"> </a></td><td>Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day</td><td/></tr><tr><td style="white-space:nowrap">GH<a name="procedure-modifier-GH"> </a></td><td>Diagnostic mammogram converted from screening mammogram on same day</td><td/></tr><tr><td style="white-space:nowrap">GI<a name="procedure-modifier-GI"> </a></td><td>AMB-hosp ESRD-transfer</td><td>Ambulance from hosp-based ESRD facility to ambulance mode transfer</td></tr><tr><td style="white-space:nowrap">GJ<a name="procedure-modifier-GJ"> </a></td><td>Opt out emerg svc</td><td>Opt out physician or practitioner emergency or urgent service</td></tr><tr><td style="white-space:nowrap">GK<a name="procedure-modifier-GK"> </a></td><td>Reasonable and necessary item/service associated with a ga or gz modifier</td><td/></tr><tr><td style="white-space:nowrap">GL<a name="procedure-modifier-GL"> </a></td><td>Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)</td><td/></tr><tr><td style="white-space:nowrap">GM<a name="procedure-modifier-GM"> </a></td><td>Multiple patients on one ambulance trip</td><td/></tr><tr><td style="white-space:nowrap">GN<a name="procedure-modifier-GN"> </a></td><td>Services delivered under an outpatient speech language pathology plan of care</td><td/></tr><tr><td style="white-space:nowrap">GO<a name="procedure-modifier-GO"> </a></td><td>Services delivered under an outpatient occupational therapy plan of care</td><td/></tr><tr><td style="white-space:nowrap">GP<a name="procedure-modifier-GP"> </a></td><td>Services delivered under an outpatient physical therapy plan of care</td><td/></tr><tr><td style="white-space:nowrap">GQ<a name="procedure-modifier-GQ"> </a></td><td>Via asynchronous telecommunications system</td><td/></tr><tr><td style="white-space:nowrap">GR<a name="procedure-modifier-GR"> </a></td><td>This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy</td><td/></tr><tr><td style="white-space:nowrap">GS<a name="procedure-modifier-GS"> </a></td><td>Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level</td><td/></tr><tr><td style="white-space:nowrap">GT<a name="procedure-modifier-GT"> </a></td><td>Via interactive audio and video telecommunication systems</td><td/></tr><tr><td style="white-space:nowrap">GU<a name="procedure-modifier-GU"> </a></td><td>Waiver of liability statement issued as required by payer policy, routine notice</td><td/></tr><tr><td style="white-space:nowrap">GV<a name="procedure-modifier-GV"> </a></td><td>Attending physician not employed or paid under arrangement by the patient's hospice provider</td><td/></tr><tr><td style="white-space:nowrap">GW<a name="procedure-modifier-GW"> </a></td><td>Service not related to the hospice patient's terminal condition</td><td/></tr><tr><td style="white-space:nowrap">GX<a name="procedure-modifier-GX"> </a></td><td>Notice of liability issued, voluntary under payer policy</td><td/></tr><tr><td style="white-space:nowrap">GY<a name="procedure-modifier-GY"> </a></td><td>Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit</td><td/></tr><tr><td style="white-space:nowrap">GZ<a name="procedure-modifier-GZ"> </a></td><td>Item or service expected to be denied as not reasonable and necessary</td><td/></tr><tr><td style="white-space:nowrap">H9<a name="procedure-modifier-H9"> </a></td><td>Court-ordered</td><td/></tr><tr><td style="white-space:nowrap">HA<a name="procedure-modifier-HA"> </a></td><td>Child/adolescent program</td><td/></tr><tr><td style="white-space:nowrap">HB<a name="procedure-modifier-HB"> </a></td><td>Adult program, non geriatric</td><td/></tr><tr><td style="white-space:nowrap">HC<a name="procedure-modifier-HC"> </a></td><td>Adult program, geriatric</td><td/></tr><tr><td style="white-space:nowrap">HD<a name="procedure-modifier-HD"> </a></td><td>Pregnant/parenting women's program</td><td/></tr><tr><td style="white-space:nowrap">HE<a name="procedure-modifier-HE"> </a></td><td>Mental health program</td><td/></tr><tr><td style="white-space:nowrap">HF<a name="procedure-modifier-HF"> </a></td><td>Substance abuse program</td><td/></tr><tr><td style="white-space:nowrap">HG<a name="procedure-modifier-HG"> </a></td><td>Opioid addiction treatment program</td><td/></tr><tr><td style="white-space:nowrap">HH<a name="procedure-modifier-HH"> </a></td><td>Integrated mental health/substance abuse program</td><td/></tr><tr><td style="white-space:nowrap">HI<a name="procedure-modifier-HI"> </a></td><td>Integrated mental health and intellectual disability/developmental disabilities program</td><td/></tr><tr><td style="white-space:nowrap">HJ<a name="procedure-modifier-HJ"> </a></td><td>Employee assistance program</td><td/></tr><tr><td style="white-space:nowrap">HK<a name="procedure-modifier-HK"> </a></td><td>Specialized mental health programs for high-risk populations</td><td/></tr><tr><td style="white-space:nowrap">HL<a name="procedure-modifier-HL"> </a></td><td>Intern</td><td/></tr><tr><td style="white-space:nowrap">HM<a name="procedure-modifier-HM"> </a></td><td>Less than bachelor degree level</td><td/></tr><tr><td style="white-space:nowrap">HN<a name="procedure-modifier-HN"> </a></td><td>Bachelors degree level</td><td/></tr><tr><td style="white-space:nowrap">HO<a name="procedure-modifier-HO"> </a></td><td>Masters degree level</td><td/></tr><tr><td style="white-space:nowrap">HP<a name="procedure-modifier-HP"> </a></td><td>Doctoral level</td><td/></tr><tr><td style="white-space:nowrap">HQ<a name="procedure-modifier-HQ"> </a></td><td>Group setting</td><td/></tr><tr><td style="white-space:nowrap">HR<a name="procedure-modifier-HR"> </a></td><td>Family/couple with client present</td><td/></tr><tr><td style="white-space:nowrap">HS<a name="procedure-modifier-HS"> </a></td><td>Family/couple without client present</td><td/></tr><tr><td style="white-space:nowrap">HT<a name="procedure-modifier-HT"> </a></td><td>Multi-disciplinary team</td><td/></tr><tr><td style="white-space:nowrap">HU<a name="procedure-modifier-HU"> </a></td><td>Funded by child welfare agency</td><td/></tr><tr><td style="white-space:nowrap">HV<a name="procedure-modifier-HV"> </a></td><td>Funded state addictions agency</td><td/></tr><tr><td style="white-space:nowrap">HW<a name="procedure-modifier-HW"> </a></td><td>Funded by state mental health agency</td><td/></tr><tr><td style="white-space:nowrap">HX<a name="procedure-modifier-HX"> </a></td><td>Funded by county/local agency</td><td/></tr><tr><td style="white-space:nowrap">HY<a name="procedure-modifier-HY"> </a></td><td>Funded by juvenile justice agency</td><td/></tr><tr><td style="white-space:nowrap">HZ<a name="procedure-modifier-HZ"> </a></td><td>Funded by criminal justice agency</td><td/></tr><tr><td style="white-space:nowrap">ID<a name="procedure-modifier-ID"> </a></td><td>AMB-transf site to NEC</td><td>Ambulance service from AMB mode transfer site to diagnostic or therapeutic site NEC</td></tr><tr><td style="white-space:nowrap">IE<a name="procedure-modifier-IE"> </a></td><td>AMB-transf site to RES</td><td>Ambulance service from AMB mode transfer site to RES facility</td></tr><tr><td style="white-space:nowrap">IG<a name="procedure-modifier-IG"> </a></td><td>AMB-transf site-ESRD</td><td>Ambulance service from AMB mode transf site to hosp ESRD facility</td></tr><tr><td style="white-space:nowrap">IH<a name="procedure-modifier-IH"> </a></td><td>AMB-transf site to hosp</td><td>Ambulance service from AMB mode transfer site to hospital</td></tr><tr><td style="white-space:nowrap">II<a name="procedure-modifier-II"> </a></td><td>AMB-transf site-transf</td><td>Ambulance service from AMB mode transf site to AMB mode transfer</td></tr><tr><td style="white-space:nowrap">IJ<a name="procedure-modifier-IJ"> </a></td><td>AMB-transf site-FS ESRD</td><td>Ambulance service from AMB mode transf site to free stand ESRD facility</td></tr><tr><td style="white-space:nowrap">IN<a name="procedure-modifier-IN"> </a></td><td>AMB-transf site to SNF</td><td>Ambulance service from AMB mode transfer site to SNF</td></tr><tr><td style="white-space:nowrap">IP<a name="procedure-modifier-IP"> </a></td><td>AMB-transf site to OV</td><td>Ambulance service from AMB mode transfer site to phys office</td></tr><tr><td style="white-space:nowrap">IR<a name="procedure-modifier-IR"> </a></td><td>AMB-transf site to home</td><td>Ambulance service from AMB mode transfer site to residence</td></tr><tr><td style="white-space:nowrap">IS<a name="procedure-modifier-IS"> </a></td><td>AMB-transf site to accid</td><td>Ambulance service from transfer site to accident scene</td></tr><tr><td style="white-space:nowrap">IX<a name="procedure-modifier-IX"> </a></td><td>AMB-transf site-OV/hosp</td><td>Ambulance service from AMB mode transf site to OV/hospital</td></tr><tr><td style="white-space:nowrap">J1<a name="procedure-modifier-J1"> </a></td><td>Competitive acquisition program no-pay submission for a prescription number</td><td/></tr><tr><td style="white-space:nowrap">J2<a name="procedure-modifier-J2"> </a></td><td>Competitive acquisition program, restocking of emergency drugs after emergency administration</td><td/></tr><tr><td style="white-space:nowrap">J3<a name="procedure-modifier-J3"> </a></td><td>Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology</td><td/></tr><tr><td style="white-space:nowrap">J4<a name="procedure-modifier-J4"> </a></td><td>Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge</td><td/></tr><tr><td style="white-space:nowrap">JA<a name="procedure-modifier-JA"> </a></td><td>Administered intravenously</td><td/></tr><tr><td style="white-space:nowrap">JB<a name="procedure-modifier-JB"> </a></td><td>Administered subcutaneously</td><td/></tr><tr><td style="white-space:nowrap">JC<a name="procedure-modifier-JC"> </a></td><td>Skin substitute used as a graft</td><td/></tr><tr><td style="white-space:nowrap">JD<a name="procedure-modifier-JD"> </a></td><td>Skin substitute not used as a graft</td><td/></tr><tr><td style="white-space:nowrap">JE<a name="procedure-modifier-JE"> </a></td><td>Administered via dialysate</td><td/></tr><tr><td style="white-space:nowrap">JF<a name="procedure-modifier-JF"> </a></td><td>Compounded drug</td><td/></tr><tr><td style="white-space:nowrap">JG<a name="procedure-modifier-JG"> </a></td><td>Drug or biological acquired with 340b drug pricing program discount</td><td/></tr><tr><td style="white-space:nowrap">JH<a name="procedure-modifier-JH"> </a></td><td>AMB-free stand ESRD-hosp</td><td>Ambulance service from free standing ESRD facility to hospital</td></tr><tr><td style="white-space:nowrap">JI<a name="procedure-modifier-JI"> </a></td><td>AMB-FS ESRD-transf site</td><td>Ambulance service from free standing ESRD fac to AMB transf site</td></tr><tr><td style="white-space:nowrap">JJ<a name="procedure-modifier-JJ"> </a></td><td>AMB-free stand ESRD-same</td><td>Ambulance service from free standing ESRD facility to free standing ESRD facility</td></tr><tr><td style="white-space:nowrap">JN<a name="procedure-modifier-JN"> </a></td><td>AMB-free stand ESRD-SNF</td><td>Ambulance service from free standing ESRD facility to skilled nursing facility (SNF)</td></tr><tr><td style="white-space:nowrap">JP<a name="procedure-modifier-JP"> </a></td><td>AMB-free stand ESRD-OV</td><td>Ambulance service from free standing ESRD facility to physician's office</td></tr><tr><td style="white-space:nowrap">JR<a name="procedure-modifier-JR"> </a></td><td>AMB-free stand ESRD-home</td><td>Ambulance service from free standing ESRD facility to residence</td></tr><tr><td style="white-space:nowrap">JS<a name="procedure-modifier-JS"> </a></td><td>AMB-FS ESRD to accident</td><td>Ambulance service from free standing ESRD facility to scene of accident or acute event</td></tr><tr><td style="white-space:nowrap">JW<a name="procedure-modifier-JW"> </a></td><td>Drug amount discarded/not administered to any patient</td><td/></tr><tr><td style="white-space:nowrap">JX<a name="procedure-modifier-JX"> </a></td><td>AMB-FS ESRD-hosp w OV</td><td>Ambulance service from free standing ESRD facility to hospital with intermediate stop at physician's office</td></tr><tr><td style="white-space:nowrap">K0<a name="procedure-modifier-K0"> </a></td><td>Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.</td><td/></tr><tr><td style="white-space:nowrap">K1<a name="procedure-modifier-K1"> </a></td><td>Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.</td><td/></tr><tr><td style="white-space:nowrap">K2<a name="procedure-modifier-K2"> </a></td><td>Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces.  typical of the limited community ambulator.</td><td/></tr><tr><td style="white-space:nowrap">K3<a name="procedure-modifier-K3"> </a></td><td>Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence.  typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.</td><td/></tr><tr><td style="white-space:nowrap">K4<a name="procedure-modifier-K4"> </a></td><td>Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.</td><td/></tr><tr><td style="white-space:nowrap">KA<a name="procedure-modifier-KA"> </a></td><td>Add on option/accessory for wheelchair</td><td/></tr><tr><td style="white-space:nowrap">KB<a name="procedure-modifier-KB"> </a></td><td>Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim</td><td/></tr><tr><td style="white-space:nowrap">KC<a name="procedure-modifier-KC"> </a></td><td>Replacement of special power wheelchair interface</td><td/></tr><tr><td style="white-space:nowrap">KD<a name="procedure-modifier-KD"> </a></td><td>Drug or biological infused through dme</td><td/></tr><tr><td style="white-space:nowrap">KE<a name="procedure-modifier-KE"> </a></td><td>Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment</td><td/></tr><tr><td style="white-space:nowrap">KF<a name="procedure-modifier-KF"> </a></td><td>Item designated by fda as class iii device</td><td/></tr><tr><td style="white-space:nowrap">KG<a name="procedure-modifier-KG"> </a></td><td>Dmepos item subject to dmepos competitive bidding program number 1</td><td/></tr><tr><td style="white-space:nowrap">KH<a name="procedure-modifier-KH"> </a></td><td>Dmepos item, initial claim, purchase or first month rental</td><td/></tr><tr><td style="white-space:nowrap">KI<a name="procedure-modifier-KI"> </a></td><td>Dmepos item, second or third month rental</td><td/></tr><tr><td style="white-space:nowrap">KJ<a name="procedure-modifier-KJ"> </a></td><td>Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen</td><td/></tr><tr><td style="white-space:nowrap">KK<a name="procedure-modifier-KK"> </a></td><td>Dmepos item subject to dmepos competitive bidding program number 2</td><td/></tr><tr><td style="white-space:nowrap">KL<a name="procedure-modifier-KL"> </a></td><td>Dmepos item delivered via mail</td><td/></tr><tr><td style="white-space:nowrap">KM<a name="procedure-modifier-KM"> </a></td><td>Replacement of facial prosthesis including new impression/moulage</td><td/></tr><tr><td style="white-space:nowrap">KN<a name="procedure-modifier-KN"> </a></td><td>Replacement of facial prosthesis using previous master model</td><td/></tr><tr><td style="white-space:nowrap">KO<a name="procedure-modifier-KO"> </a></td><td>Single drug unit dose formulation</td><td/></tr><tr><td style="white-space:nowrap">KP<a name="procedure-modifier-KP"> </a></td><td>First drug of a multiple drug unit dose formulation</td><td/></tr><tr><td style="white-space:nowrap">KQ<a name="procedure-modifier-KQ"> </a></td><td>Second or subsequent drug of a multiple drug unit dose formulation</td><td/></tr><tr><td style="white-space:nowrap">KR<a name="procedure-modifier-KR"> </a></td><td>Rental item, billing for partial month</td><td/></tr><tr><td style="white-space:nowrap">KS<a name="procedure-modifier-KS"> </a></td><td>Glucose monitor supply for diabetic beneficiary not treated with insulin</td><td/></tr><tr><td style="white-space:nowrap">KT<a name="procedure-modifier-KT"> </a></td><td>Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item</td><td/></tr><tr><td style="white-space:nowrap">KU<a name="procedure-modifier-KU"> </a></td><td>Dmepos item subject to dmepos competitive bidding program number 3</td><td/></tr><tr><td style="white-space:nowrap">KV<a name="procedure-modifier-KV"> </a></td><td>Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service</td><td/></tr><tr><td style="white-space:nowrap">KW<a name="procedure-modifier-KW"> </a></td><td>Dmepos item subject to dmepos competitive bidding program number 4</td><td/></tr><tr><td style="white-space:nowrap">KX<a name="procedure-modifier-KX"> </a></td><td>Requirements specified in the medical policy have been met</td><td/></tr><tr><td style="white-space:nowrap">KY<a name="procedure-modifier-KY"> </a></td><td>Dmepos item subject to dmepos competitive bidding program number 5</td><td/></tr><tr><td style="white-space:nowrap">KZ<a name="procedure-modifier-KZ"> </a></td><td>New coverage not implemented by managed care</td><td/></tr><tr><td style="white-space:nowrap">L1<a name="procedure-modifier-L1"> </a></td><td>Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps</td><td/></tr><tr><td style="white-space:nowrap">LC<a name="procedure-modifier-LC"> </a></td><td>Left circumflex coronary artery</td><td/></tr><tr><td style="white-space:nowrap">LD<a name="procedure-modifier-LD"> </a></td><td>Left anterior descending coronary artery</td><td/></tr><tr><td style="white-space:nowrap">LL<a name="procedure-modifier-LL"> </a></td><td>Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)</td><td/></tr><tr><td style="white-space:nowrap">LM<a name="procedure-modifier-LM"> </a></td><td>Left main coronary artery</td><td/></tr><tr><td style="white-space:nowrap">LR<a name="procedure-modifier-LR"> </a></td><td>Laboratory round trip</td><td/></tr><tr><td style="white-space:nowrap">LS<a name="procedure-modifier-LS"> </a></td><td>Fda-monitored intraocular lens implant</td><td/></tr><tr><td style="white-space:nowrap">LT<a name="procedure-modifier-LT"> </a></td><td>Left side (used to identify procedures performed on the left side of the body)</td><td/></tr><tr><td style="white-space:nowrap">M2<a name="procedure-modifier-M2"> </a></td><td>Medicare secondary payer (msp)</td><td/></tr><tr><td style="white-space:nowrap">MA<a name="procedure-modifier-MA"> </a></td><td>Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition</td><td/></tr><tr><td style="white-space:nowrap">MB<a name="procedure-modifier-MB"> </a></td><td>Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access</td><td/></tr><tr><td style="white-space:nowrap">MC<a name="procedure-modifier-MC"> </a></td><td>Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues</td><td/></tr><tr><td style="white-space:nowrap">MD<a name="procedure-modifier-MD"> </a></td><td>Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances</td><td/></tr><tr><td style="white-space:nowrap">ME<a name="procedure-modifier-ME"> </a></td><td>The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional</td><td/></tr><tr><td style="white-space:nowrap">MF<a name="procedure-modifier-MF"> </a></td><td>The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional</td><td/></tr><tr><td style="white-space:nowrap">MG<a name="procedure-modifier-MG"> </a></td><td>The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional</td><td/></tr><tr><td style="white-space:nowrap">MH<a name="procedure-modifier-MH"> </a></td><td>Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider</td><td/></tr><tr><td style="white-space:nowrap">MS<a name="procedure-modifier-MS"> </a></td><td>Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty</td><td/></tr><tr><td style="white-space:nowrap">NB<a name="procedure-modifier-NB"> </a></td><td>Nebulizer system, any type, fda-cleared for use with specific drug</td><td/></tr><tr><td style="white-space:nowrap">ND<a name="procedure-modifier-ND"> </a></td><td>AMB-SNF to site NEC</td><td>Ambulance service from skilled nursing facility (SNF) to diagnostic or therapeutic site other than P or H</td></tr><tr><td style="white-space:nowrap">NE<a name="procedure-modifier-NE"> </a></td><td>AMB-SNF to RES facility</td><td>Ambulance service from skilled nursing facility (SNF) to residential facility</td></tr><tr><td style="white-space:nowrap">NG<a name="procedure-modifier-NG"> </a></td><td>AMB-SNF to hosp ESRD</td><td>Ambulance service from skilled nursing facility (SNF) to a hospital-based ESRD facility</td></tr><tr><td style="white-space:nowrap">NH<a name="procedure-modifier-NH"> </a></td><td>AMB-SNF to hosp|Ambulance from skilled nursing facility to hosp|Ambulance service from skilled nursing facility (SNF) to hospital</td><td/></tr><tr><td style="white-space:nowrap">NI<a name="procedure-modifier-NI"> </a></td><td>AMB-SNF to transf site</td><td>Ambulance service from SNF to AMB mode transfer site</td></tr><tr><td style="white-space:nowrap">NJ<a name="procedure-modifier-NJ"> </a></td><td>AMB-SNF-free stand ESRD</td><td>Ambulance service from skilled nursing facility (SNF) to a free standing ESRD facility</td></tr><tr><td style="white-space:nowrap">NN<a name="procedure-modifier-NN"> </a></td><td>Ambulance-SNF to SNF</td><td>Ambulance service from skilled nursing facility (SNF) to skilled nursing facility (SNF)</td></tr><tr><td style="white-space:nowrap">NP<a name="procedure-modifier-NP"> </a></td><td>AMB-SNF to phys office</td><td>Ambulance service from skilled nursing facility (SNF) to physician's office</td></tr><tr><td style="white-space:nowrap">NR<a name="procedure-modifier-NR"> </a></td><td>New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)</td><td/></tr><tr><td style="white-space:nowrap">NS<a name="procedure-modifier-NS"> </a></td><td>AMB-SNF to accident</td><td>Ambulance service from skilled nursing facility (SNF) to scene of accident or acute event</td></tr><tr><td style="white-space:nowrap">NU<a name="procedure-modifier-NU"> </a></td><td>New equipment</td><td/></tr><tr><td style="white-space:nowrap">NX<a name="procedure-modifier-NX"> </a></td><td>AMB-SNF to hosp w OV</td><td>Ambulance service from skilled nursing facility (SNF) to hospital with intermediate stop at physician's office</td></tr><tr><td style="white-space:nowrap">P1<a name="procedure-modifier-P1"> </a></td><td>A normal healthy patient</td><td/></tr><tr><td style="white-space:nowrap">P2<a name="procedure-modifier-P2"> </a></td><td>A patient with mild systemic disease</td><td/></tr><tr><td style="white-space:nowrap">P3<a name="procedure-modifier-P3"> </a></td><td>A patient with severe systemic disease</td><td/></tr><tr><td style="white-space:nowrap">P4<a name="procedure-modifier-P4"> </a></td><td>A patient with severe systemic disease that is a constant threat to life</td><td/></tr><tr><td style="white-space:nowrap">P5<a name="procedure-modifier-P5"> </a></td><td>A moribund patient who is not expected to survive without the operation</td><td/></tr><tr><td style="white-space:nowrap">P6<a name="procedure-modifier-P6"> </a></td><td>A declared brain-dead patient whose organs are being removed for donor purposes</td><td/></tr><tr><td style="white-space:nowrap">PA<a name="procedure-modifier-PA"> </a></td><td>Surgical or other invasive procedure on wrong body part</td><td/></tr><tr><td style="white-space:nowrap">PB<a name="procedure-modifier-PB"> </a></td><td>Surgical or other invasive procedure on wrong patient</td><td/></tr><tr><td style="white-space:nowrap">PC<a name="procedure-modifier-PC"> </a></td><td>Wrong surgery or other invasive procedure on patient</td><td/></tr><tr><td style="white-space:nowrap">PD<a name="procedure-modifier-PD"> </a></td><td>Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days</td><td/></tr><tr><td style="white-space:nowrap">PE<a name="procedure-modifier-PE"> </a></td><td>AMB-OV to RES fac</td><td>Ambulance service from physician's office to residential facility</td></tr><tr><td style="white-space:nowrap">PG<a name="procedure-modifier-PG"> </a></td><td>AMB-OV to hosp ESRD</td><td>Ambulance service from physician's office to a hospital-based ESRD facility</td></tr><tr><td style="white-space:nowrap">PH<a name="procedure-modifier-PH"> </a></td><td>AMB-phys office to hosp</td><td>Ambulance service from physician's office to hospital</td></tr><tr><td style="white-space:nowrap">PI<a name="procedure-modifier-PI"> </a></td><td>Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing</td><td/></tr><tr><td style="white-space:nowrap">PJ<a name="procedure-modifier-PJ"> </a></td><td>AMB-OV to FS ESRD</td><td>Ambulance service from physician's office to free standing ESRD facility</td></tr><tr><td style="white-space:nowrap">PL<a name="procedure-modifier-PL"> </a></td><td>Progressive addition lenses</td><td/></tr><tr><td style="white-space:nowrap">PM<a name="procedure-modifier-PM"> </a></td><td>Post mortem</td><td/></tr><tr><td style="white-space:nowrap">PN<a name="procedure-modifier-PN"> </a></td><td>Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital</td><td/></tr><tr><td style="white-space:nowrap">PO<a name="procedure-modifier-PO"> </a></td><td>Excepted service provided at an off-campus, outpatient, provider-based department of a hospital</td><td/></tr><tr><td style="white-space:nowrap">PR<a name="procedure-modifier-PR"> </a></td><td>AMB-phys office to home</td><td>Ambulance service from physician's office to residence</td></tr><tr><td style="white-space:nowrap">PS<a name="procedure-modifier-PS"> </a></td><td>Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy</td><td/></tr><tr><td style="white-space:nowrap">PT<a name="procedure-modifier-PT"> </a></td><td>Colorectal cancer screening test; converted to diagnostic test or other procedure</td><td/></tr><tr><td style="white-space:nowrap">PX<a name="procedure-modifier-PX"> </a></td><td>AMB-OV to hosp+OV</td><td>Ambulance service from physician's office to hospital with intermediate stop at physician's office</td></tr><tr><td style="white-space:nowrap">Q0<a name="procedure-modifier-Q0"> </a></td><td>Investigational clinical service provided in a clinical research study that is in an approved clinical research study</td><td/></tr><tr><td style="white-space:nowrap">Q1<a name="procedure-modifier-Q1"> </a></td><td>Routine clinical service provided in a clinical research study that is in an approved clinical research study</td><td/></tr><tr><td style="white-space:nowrap">Q2<a name="procedure-modifier-Q2"> </a></td><td>Demonstration procedure/service</td><td/></tr><tr><td style="white-space:nowrap">Q3<a name="procedure-modifier-Q3"> </a></td><td>Live kidney donor surgery and related services</td><td/></tr><tr><td style="white-space:nowrap">Q4<a name="procedure-modifier-Q4"> </a></td><td>Service for ordering/referring physician qualifies as a service exemption</td><td/></tr><tr><td style="white-space:nowrap">Q5<a name="procedure-modifier-Q5"> </a></td><td>Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area</td><td/></tr><tr><td style="white-space:nowrap">Q6<a name="procedure-modifier-Q6"> </a></td><td>Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area</td><td/></tr><tr><td style="white-space:nowrap">Q7<a name="procedure-modifier-Q7"> </a></td><td>One class a finding</td><td/></tr><tr><td style="white-space:nowrap">Q8<a name="procedure-modifier-Q8"> </a></td><td>Two class b findings</td><td/></tr><tr><td style="white-space:nowrap">Q9<a name="procedure-modifier-Q9"> </a></td><td>One class b and two class c findings</td><td/></tr><tr><td style="white-space:nowrap">QA<a name="procedure-modifier-QA"> </a></td><td>Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)</td><td/></tr><tr><td style="white-space:nowrap">QB<a name="procedure-modifier-QB"> </a></td><td>Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed</td><td/></tr><tr><td style="white-space:nowrap">QC<a name="procedure-modifier-QC"> </a></td><td>Single channel monitoring</td><td/></tr><tr><td style="white-space:nowrap">QD<a name="procedure-modifier-QD"> </a></td><td>Recording and storage in solid state memory by a digital recorder</td><td/></tr><tr><td style="white-space:nowrap">QE<a name="procedure-modifier-QE"> </a></td><td>Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)</td><td/></tr><tr><td style="white-space:nowrap">QF<a name="procedure-modifier-QF"> </a></td><td>Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed</td><td/></tr><tr><td style="white-space:nowrap">QG<a name="procedure-modifier-QG"> </a></td><td>Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)</td><td/></tr><tr><td style="white-space:nowrap">QH<a name="procedure-modifier-QH"> </a></td><td>Oxygen conserving device is being used with an oxygen delivery system</td><td/></tr><tr><td style="white-space:nowrap">QJ<a name="procedure-modifier-QJ"> </a></td><td>Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)</td><td/></tr><tr><td style="white-space:nowrap">QK<a name="procedure-modifier-QK"> </a></td><td>Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals</td><td/></tr><tr><td style="white-space:nowrap">QL<a name="procedure-modifier-QL"> </a></td><td>Patient pronounced dead after ambulance called</td><td/></tr><tr><td style="white-space:nowrap">QM<a name="procedure-modifier-QM"> </a></td><td>Ambulance service provided under arrangement by a provider of services</td><td/></tr><tr><td style="white-space:nowrap">QN<a name="procedure-modifier-QN"> </a></td><td>Ambulance service furnished directly by a provider of services</td><td/></tr><tr><td style="white-space:nowrap">QP<a name="procedure-modifier-QP"> </a></td><td>Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060.</td><td/></tr><tr><td style="white-space:nowrap">QQ<a name="procedure-modifier-QQ"> </a></td><td>Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional</td><td/></tr><tr><td style="white-space:nowrap">QR<a name="procedure-modifier-QR"> </a></td><td>Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)</td><td/></tr><tr><td style="white-space:nowrap">QS<a name="procedure-modifier-QS"> </a></td><td>Monitored anesthesia care service</td><td/></tr><tr><td style="white-space:nowrap">QT<a name="procedure-modifier-QT"> </a></td><td>Recording and storage on tape by an analog tape recorder</td><td/></tr><tr><td style="white-space:nowrap">QW<a name="procedure-modifier-QW"> </a></td><td>Clia waived test</td><td/></tr><tr><td style="white-space:nowrap">QX<a name="procedure-modifier-QX"> </a></td><td>Crna service: with medical direction by a physician</td><td/></tr><tr><td style="white-space:nowrap">QY<a name="procedure-modifier-QY"> </a></td><td>Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist</td><td/></tr><tr><td style="white-space:nowrap">QZ<a name="procedure-modifier-QZ"> </a></td><td>Crna service: without medical direction by a physician</td><td/></tr><tr><td style="white-space:nowrap">RA<a name="procedure-modifier-RA"> </a></td><td>Replacement of a dme, orthotic or prosthetic item</td><td/></tr><tr><td style="white-space:nowrap">RB<a name="procedure-modifier-RB"> </a></td><td>Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair</td><td/></tr><tr><td style="white-space:nowrap">RC<a name="procedure-modifier-RC"> </a></td><td>Right coronary artery</td><td/></tr><tr><td style="white-space:nowrap">RD<a name="procedure-modifier-RD"> </a></td><td>Drug provided to beneficiary, but not administered incident-to</td><td/></tr><tr><td style="white-space:nowrap">RE<a name="procedure-modifier-RE"> </a></td><td>Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)</td><td/></tr><tr><td style="white-space:nowrap">RG<a name="procedure-modifier-RG"> </a></td><td>AMB-home to hosp ESRD</td><td>Ambulance service from residence to hospital-based ESRD facility</td></tr><tr><td style="white-space:nowrap">RH<a name="procedure-modifier-RH"> </a></td><td>AMB-home to hosp</td><td>Ambulance service from residence to hospital</td></tr><tr><td style="white-space:nowrap">RI<a name="procedure-modifier-RI"> </a></td><td>Ramus intermedius coronary artery</td><td/></tr><tr><td style="white-space:nowrap">RJ<a name="procedure-modifier-RJ"> </a></td><td>AMB-home-free stand ESRD</td><td>Ambulance service from residence to free standing ESRD facility</td></tr><tr><td style="white-space:nowrap">RN<a name="procedure-modifier-RN"> </a></td><td>AMB-home to SNF</td><td>Ambulance service from residence to skilled nursing facility (SNF)</td></tr><tr><td style="white-space:nowrap">RP<a name="procedure-modifier-RP"> </a></td><td>AMB-home to phys office</td><td>Ambulance service from residence to physician's office</td></tr><tr><td style="white-space:nowrap">RR<a name="procedure-modifier-RR"> </a></td><td>Rental (use the 'rr' modifier when dme is to be rented)</td><td/></tr><tr><td style="white-space:nowrap">RS<a name="procedure-modifier-RS"> </a></td><td>AMB-home to accident</td><td>Ambulance service from residence to scene of accident or acute event</td></tr><tr><td style="white-space:nowrap">RT<a name="procedure-modifier-RT"> </a></td><td>Right side (used to identify procedures performed on the right side of the body)</td><td/></tr><tr><td style="white-space:nowrap">RX<a name="procedure-modifier-RX"> </a></td><td>AMB-home to hosp w OV</td><td>Ambulance service from residence to hospital with intermediate stop at physician's office</td></tr><tr><td style="white-space:nowrap">SA<a name="procedure-modifier-SA"> </a></td><td>Nurse practitioner rendering service in collaboration with a physician</td><td/></tr><tr><td style="white-space:nowrap">SB<a name="procedure-modifier-SB"> </a></td><td>Nurse midwife</td><td/></tr><tr><td style="white-space:nowrap">SC<a name="procedure-modifier-SC"> </a></td><td>Medically necessary service or supply</td><td/></tr><tr><td style="white-space:nowrap">SD<a name="procedure-modifier-SD"> </a></td><td>Services provided by registered nurse with specialized, highly technical home infusion training</td><td/></tr><tr><td style="white-space:nowrap">SE<a name="procedure-modifier-SE"> </a></td><td>State and/or federally-funded programs/services</td><td/></tr><tr><td style="white-space:nowrap">SF<a name="procedure-modifier-SF"> </a></td><td>Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)</td><td/></tr><tr><td style="white-space:nowrap">SG<a name="procedure-modifier-SG"> </a></td><td>Ambulatory surgical center (asc) facility service</td><td/></tr><tr><td style="white-space:nowrap">SH<a name="procedure-modifier-SH"> </a></td><td>Second concurrently administered infusion therapy</td><td/></tr><tr><td style="white-space:nowrap">SI<a name="procedure-modifier-SI"> </a></td><td>AMB-accident to transf</td><td>Ambulance from accident scene to AMB mode transfer site</td></tr><tr><td style="white-space:nowrap">SJ<a name="procedure-modifier-SJ"> </a></td><td>Third or more concurrently administered infusion therapy</td><td/></tr><tr><td style="white-space:nowrap">SK<a name="procedure-modifier-SK"> </a></td><td>Member of high risk population (use only with codes for immunization)</td><td/></tr><tr><td style="white-space:nowrap">SL<a name="procedure-modifier-SL"> </a></td><td>State supplied vaccine</td><td/></tr><tr><td style="white-space:nowrap">SM<a name="procedure-modifier-SM"> </a></td><td>Second surgical opinion</td><td/></tr><tr><td style="white-space:nowrap">SN<a name="procedure-modifier-SN"> </a></td><td>Third surgical opinion</td><td/></tr><tr><td style="white-space:nowrap">SP<a name="procedure-modifier-SP"> </a></td><td>AMB-accident to OV</td><td>Ambulance service from scene of accident or acute event to physician's office</td></tr><tr><td style="white-space:nowrap">SQ<a name="procedure-modifier-SQ"> </a></td><td>Item ordered by home health</td><td/></tr><tr><td style="white-space:nowrap">SR<a name="procedure-modifier-SR"> </a></td><td>AMB-accident to home</td><td>Ambulance service from scene of accident or acute event to residence</td></tr><tr><td style="white-space:nowrap">SS<a name="procedure-modifier-SS"> </a></td><td>Home infusion services provided in the infusion suite of the iv therapy provider</td><td/></tr><tr><td style="white-space:nowrap">ST<a name="procedure-modifier-ST"> </a></td><td>Related to trauma or injury</td><td/></tr><tr><td style="white-space:nowrap">SU<a name="procedure-modifier-SU"> </a></td><td>Procedure performed in physician's office (to denote use of facility and equipment)</td><td/></tr><tr><td style="white-space:nowrap">SV<a name="procedure-modifier-SV"> </a></td><td>Pharmaceuticals delivered to patient's home but not utilized</td><td/></tr><tr><td style="white-space:nowrap">SW<a name="procedure-modifier-SW"> </a></td><td>Services provided by a certified diabetic educator</td><td/></tr><tr><td style="white-space:nowrap">SX<a name="procedure-modifier-SX"> </a></td><td>AMB-accident to hosp+OV</td><td>Ambulance service from scene of accident or acute event to hospital with intermediate stop at physician's office</td></tr><tr><td style="white-space:nowrap">SY<a name="procedure-modifier-SY"> </a></td><td>Persons who are in close contact with member of high-risk population (use only with codes for immunization)</td><td/></tr><tr><td style="white-space:nowrap">SZ<a name="procedure-modifier-SZ"> </a></td><td>Habilitative services</td><td/></tr><tr><td style="white-space:nowrap">T1<a name="procedure-modifier-T1"> </a></td><td>Left foot, second digit</td><td/></tr><tr><td style="white-space:nowrap">T2<a name="procedure-modifier-T2"> </a></td><td>Left foot, third digit</td><td/></tr><tr><td style="white-space:nowrap">T3<a name="procedure-modifier-T3"> </a></td><td>Left foot, fourth digit</td><td/></tr><tr><td style="white-space:nowrap">T4<a name="procedure-modifier-T4"> </a></td><td>Left foot, fifth digit</td><td/></tr><tr><td style="white-space:nowrap">T5<a name="procedure-modifier-T5"> </a></td><td>Right foot, great toe</td><td/></tr><tr><td style="white-space:nowrap">T6<a name="procedure-modifier-T6"> </a></td><td>Right foot, second digit</td><td/></tr><tr><td style="white-space:nowrap">T7<a name="procedure-modifier-T7"> </a></td><td>Right foot, third digit</td><td/></tr><tr><td style="white-space:nowrap">T8<a name="procedure-modifier-T8"> </a></td><td>Right foot, fourth digit</td><td/></tr><tr><td style="white-space:nowrap">T9<a name="procedure-modifier-T9"> </a></td><td>Right foot, fifth digit</td><td/></tr><tr><td style="white-space:nowrap">TA<a name="procedure-modifier-TA"> </a></td><td>Left foot, great toe</td><td/></tr><tr><td style="white-space:nowrap">TB<a name="procedure-modifier-TB"> </a></td><td>Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes</td><td/></tr><tr><td style="white-space:nowrap">TC<a name="procedure-modifier-TC"> </a></td><td>Technical component; under certain circumstances, a charge may be made for the technical component alone;  under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles</td><td/></tr><tr><td style="white-space:nowrap">TD<a name="procedure-modifier-TD"> </a></td><td>Rn</td><td/></tr><tr><td style="white-space:nowrap">TE<a name="procedure-modifier-TE"> </a></td><td>Lpn/lvn</td><td/></tr><tr><td style="white-space:nowrap">TF<a name="procedure-modifier-TF"> </a></td><td>Intermediate level of care</td><td/></tr><tr><td style="white-space:nowrap">TG<a name="procedure-modifier-TG"> </a></td><td>Complex/high tech level of care</td><td/></tr><tr><td style="white-space:nowrap">TH<a name="procedure-modifier-TH"> </a></td><td>Obstetrical treatment/services, prenatal or postpartum</td><td/></tr><tr><td style="white-space:nowrap">TJ<a name="procedure-modifier-TJ"> </a></td><td>Program group, child and/or adolescent</td><td/></tr><tr><td style="white-space:nowrap">TK<a name="procedure-modifier-TK"> </a></td><td>Extra patient or passenger, non-ambulance</td><td/></tr><tr><td style="white-space:nowrap">TL<a name="procedure-modifier-TL"> </a></td><td>Early intervention/individualized family service plan (ifsp)</td><td/></tr><tr><td style="white-space:nowrap">TM<a name="procedure-modifier-TM"> </a></td><td>Individualized education program (iep)</td><td/></tr><tr><td style="white-space:nowrap">TN<a name="procedure-modifier-TN"> </a></td><td>Rural/outside providers' customary service area</td><td/></tr><tr><td style="white-space:nowrap">TP<a name="procedure-modifier-TP"> </a></td><td>Medical transport, unloaded vehicle</td><td/></tr><tr><td style="white-space:nowrap">TQ<a name="procedure-modifier-TQ"> </a></td><td>Basic life support transport by a volunteer ambulance provider</td><td/></tr><tr><td style="white-space:nowrap">TR<a name="procedure-modifier-TR"> </a></td><td>School-based individualized education program (iep) services provided outside the public school district responsible for the student</td><td/></tr><tr><td style="white-space:nowrap">TS<a name="procedure-modifier-TS"> </a></td><td>Follow-up service</td><td/></tr><tr><td style="white-space:nowrap">TT<a name="procedure-modifier-TT"> </a></td><td>Individualized service provided to more than one patient in same setting</td><td/></tr><tr><td style="white-space:nowrap">TU<a name="procedure-modifier-TU"> </a></td><td>Special payment rate, overtime</td><td/></tr><tr><td style="white-space:nowrap">TV<a name="procedure-modifier-TV"> </a></td><td>Special payment rates, holidays/weekends</td><td/></tr><tr><td style="white-space:nowrap">TW<a name="procedure-modifier-TW"> </a></td><td>Back-up equipment</td><td/></tr><tr><td style="white-space:nowrap">U1<a name="procedure-modifier-U1"> </a></td><td>Medicaid level of care 1, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U2<a name="procedure-modifier-U2"> </a></td><td>Medicaid level of care 2, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U3<a name="procedure-modifier-U3"> </a></td><td>Medicaid level of care 3, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U4<a name="procedure-modifier-U4"> </a></td><td>Medicaid level of care 4, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U5<a name="procedure-modifier-U5"> </a></td><td>Medicaid level of care 5, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U6<a name="procedure-modifier-U6"> </a></td><td>Medicaid level of care 6, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U7<a name="procedure-modifier-U7"> </a></td><td>Medicaid level of care 7, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U8<a name="procedure-modifier-U8"> </a></td><td>Medicaid level of care 8, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">U9<a name="procedure-modifier-U9"> </a></td><td>Medicaid level of care 9, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">UA<a name="procedure-modifier-UA"> </a></td><td>Medicaid level of care 10, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">UB<a name="procedure-modifier-UB"> </a></td><td>Medicaid level of care 11, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">UC<a name="procedure-modifier-UC"> </a></td><td>Medicaid level of care 12, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">UD<a name="procedure-modifier-UD"> </a></td><td>Medicaid level of care 13, as defined by each state</td><td/></tr><tr><td style="white-space:nowrap">UE<a name="procedure-modifier-UE"> </a></td><td>Used durable medical equipment</td><td/></tr><tr><td style="white-space:nowrap">UF<a name="procedure-modifier-UF"> </a></td><td>Services provided in the morning</td><td/></tr><tr><td style="white-space:nowrap">UG<a name="procedure-modifier-UG"> </a></td><td>Services provided in the afternoon</td><td/></tr><tr><td style="white-space:nowrap">UH<a name="procedure-modifier-UH"> </a></td><td>Services provided in the evening</td><td/></tr><tr><td style="white-space:nowrap">UJ<a name="procedure-modifier-UJ"> </a></td><td>Services provided at night</td><td/></tr><tr><td style="white-space:nowrap">UK<a name="procedure-modifier-UK"> </a></td><td>Services provided on behalf of the client to someone other than the client (collateral relationship)</td><td/></tr><tr><td style="white-space:nowrap">UN<a name="procedure-modifier-UN"> </a></td><td>Two patients served</td><td/></tr><tr><td style="white-space:nowrap">UP<a name="procedure-modifier-UP"> </a></td><td>Three patients served</td><td/></tr><tr><td style="white-space:nowrap">UQ<a name="procedure-modifier-UQ"> </a></td><td>Four patients served</td><td/></tr><tr><td style="white-space:nowrap">UR<a name="procedure-modifier-UR"> </a></td><td>Five patients served</td><td/></tr><tr><td style="white-space:nowrap">US<a name="procedure-modifier-US"> </a></td><td>Six or more patients served</td><td/></tr><tr><td style="white-space:nowrap">V1<a name="procedure-modifier-V1"> </a></td><td>Demonstration modifier 1</td><td/></tr><tr><td style="white-space:nowrap">V2<a name="procedure-modifier-V2"> </a></td><td>Demonstration modifier 2</td><td/></tr><tr><td style="white-space:nowrap">V3<a name="procedure-modifier-V3"> </a></td><td>Demonstration modifier 3</td><td/></tr><tr><td style="white-space:nowrap">V5<a name="procedure-modifier-V5"> </a></td><td>Vascular catheter (alone or with any other vascular access)</td><td/></tr><tr><td style="white-space:nowrap">V6<a name="procedure-modifier-V6"> </a></td><td>Arteriovenous graft (or other vascular access not including a vascular catheter)</td><td/></tr><tr><td style="white-space:nowrap">V7<a name="procedure-modifier-V7"> </a></td><td>Arteriovenous fistula only (in use with two needles)</td><td/></tr><tr><td style="white-space:nowrap">V8<a name="procedure-modifier-V8"> </a></td><td>Infection present</td><td/></tr><tr><td style="white-space:nowrap">V9<a name="procedure-modifier-V9"> </a></td><td>No infection present</td><td/></tr><tr><td style="white-space:nowrap">VM<a name="procedure-modifier-VM"> </a></td><td>Medicare diabetes prevention program (mdpp) virtual make-up session</td><td/></tr><tr><td style="white-space:nowrap">VP<a name="procedure-modifier-VP"> </a></td><td>Aphakic patient</td><td/></tr><tr><td style="white-space:nowrap">X1<a name="procedure-modifier-X1"> </a></td><td>Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care</td><td/></tr><tr><td style="white-space:nowrap">X2<a name="procedure-modifier-X2"> </a></td><td>Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services</td><td/></tr><tr><td style="white-space:nowrap">X3<a name="procedure-modifier-X3"> </a></td><td>Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital</td><td/></tr><tr><td style="white-space:nowrap">X4<a name="procedure-modifier-X4"> </a></td><td>Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period</td><td/></tr><tr><td style="white-space:nowrap">X5<a name="procedure-modifier-X5"> </a></td><td>Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician</td><td/></tr><tr><td style="white-space:nowrap">XE<a name="procedure-modifier-XE"> </a></td><td>Separate encounter, a service that is distinct because it occurred during a separate encounter</td><td/></tr><tr><td style="white-space:nowrap">XP<a name="procedure-modifier-XP"> </a></td><td>Separate practitioner, a service that is distinct because it was performed by a different practitioner</td><td/></tr><tr><td style="white-space:nowrap">XS<a name="procedure-modifier-XS"> </a></td><td>Separate structure, a service that is distinct because it was performed on a separate organ/structure</td><td/></tr><tr><td style="white-space:nowrap">XU<a name="procedure-modifier-XU"> </a></td><td>Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service</td><td/></tr><tr><td style="white-space:nowrap">ZA<a name="procedure-modifier-ZA"> </a></td><td>Novartis/sandoz</td><td/></tr><tr><td style="white-space:nowrap">ZB<a name="procedure-modifier-ZB"> </a></td><td>Pfizer/hospira</td><td/></tr><tr><td style="white-space:nowrap">ZC<a name="procedure-modifier-ZC"> </a></td><td>Merck/samsung bioepis</td><td/></tr><tr><td style="white-space:nowrap">22<a name="procedure-modifier-22"> </a></td><td>Increased procedural svc</td><td>Increased procedural services</td></tr><tr><td style="white-space:nowrap">23<a name="procedure-modifier-23"> </a></td><td>Unusual anesthesia</td><td>Unusual anesthesia</td></tr><tr><td style="white-space:nowrap">24<a name="procedure-modifier-24"> </a></td><td>Oth E/M-same phys postop</td><td>Unrelated Evaluation and Management Service by the Same physician During a Postoperative Period</td></tr><tr><td style="white-space:nowrap">25<a name="procedure-modifier-25"> </a></td><td>SignificantE/M same phys/px</td><td>Significant E/M-same physician day of procedure/service</td></tr><tr><td style="white-space:nowrap">26<a name="procedure-modifier-26"> </a></td><td>Professional component</td><td>Professional component</td></tr><tr><td style="white-space:nowrap">27<a name="procedure-modifier-27"> </a></td><td>Mult outpt E/M same date</td><td>Multiple Outpatient Hospital E/M Encounters on the Same Date</td></tr><tr><td style="white-space:nowrap">32<a name="procedure-modifier-32"> </a></td><td>Mandated services</td><td>Mandated services</td></tr><tr><td style="white-space:nowrap">33<a name="procedure-modifier-33"> </a></td><td>Preventive services</td><td>Preventive services</td></tr><tr><td style="white-space:nowrap">47<a name="procedure-modifier-47"> </a></td><td>Anesthesia by surgeon</td><td>Anesthesia by surgeon</td></tr><tr><td style="white-space:nowrap">50<a name="procedure-modifier-50"> </a></td><td>Bilateral procedure</td><td>Bilateral procedure</td></tr><tr><td style="white-space:nowrap">51<a name="procedure-modifier-51"> </a></td><td>Multiple procedures</td><td>Multiple procedures</td></tr><tr><td style="white-space:nowrap">52<a name="procedure-modifier-52"> </a></td><td>Reduced services</td><td>Reduced services</td></tr><tr><td style="white-space:nowrap">53<a name="procedure-modifier-53"> </a></td><td>Discontinued procedure</td><td>Discontinued procedure</td></tr><tr><td style="white-space:nowrap">54<a name="procedure-modifier-54"> </a></td><td>Surgical care only</td><td>Surgical care only</td></tr><tr><td style="white-space:nowrap">55<a name="procedure-modifier-55"> </a></td><td>Postoperative management only</td><td>Postoperative management only</td></tr><tr><td style="white-space:nowrap">56<a name="procedure-modifier-56"> </a></td><td>Preoperative management only</td><td>Preoperative management only</td></tr><tr><td style="white-space:nowrap">57<a name="procedure-modifier-57"> </a></td><td>Decision for surgery</td><td>Decision for surgery</td></tr><tr><td style="white-space:nowrap">58<a name="procedure-modifier-58"> </a></td><td>Stg/rel px by same phys</td><td>Staged or Related Procedure or Service by the Same Physician During the Postoperative Period</td></tr><tr><td style="white-space:nowrap">59<a name="procedure-modifier-59"> </a></td><td>Distinct procedural svc</td><td>Distinct procedural service</td></tr><tr><td style="white-space:nowrap">62<a name="procedure-modifier-62"> </a></td><td>Two surgeons</td><td>Two surgeons</td></tr><tr><td style="white-space:nowrap">63<a name="procedure-modifier-63"> </a></td><td>Px on infants &lt;4 kg</td><td>Procedure performed on insants less than 4 kg</td></tr><tr><td style="white-space:nowrap">66<a name="procedure-modifier-66"> </a></td><td>Surgical team</td><td>Surgical team</td></tr><tr><td style="white-space:nowrap">73<a name="procedure-modifier-73"> </a></td><td>D/C OP/ASC px prior anes</td><td>Discontinued outpatient/ASC procedure prior to administration of anesthesia</td></tr><tr><td style="white-space:nowrap">74<a name="procedure-modifier-74"> </a></td><td>D/C OP/ASC px after anes</td><td>Discontinued outpatient/ASC procedure after administration of anesthesia</td></tr><tr><td style="white-space:nowrap">76<a name="procedure-modifier-76"> </a></td><td>Repeat px-same phys/HCP</td><td>Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional</td></tr><tr><td style="white-space:nowrap">77<a name="procedure-modifier-77"> </a></td><td>Repeat px-another phys/HCP</td><td>Repeat procedure, different provider</td></tr><tr><td style="white-space:nowrap">78<a name="procedure-modifier-78"> </a></td><td>Unplan return OR-rel px</td><td>Unplanned return to operating room during postoperative care, related procedure by the same provider</td></tr><tr><td style="white-space:nowrap">79<a name="procedure-modifier-79"> </a></td><td>Px postop-same phys</td><td>Unrelated Procedure or Service by the Same Physician During the Postoperative Period</td></tr><tr><td style="white-space:nowrap">80<a name="procedure-modifier-80"> </a></td><td>Assistant surgeon</td><td>Assistant surgeon</td></tr><tr><td style="white-space:nowrap">81<a name="procedure-modifier-81"> </a></td><td>Minimum asst surgeon</td><td>Minimum assistant surgeon</td></tr><tr><td style="white-space:nowrap">82<a name="procedure-modifier-82"> </a></td><td>Asst surgeon-no resident</td><td>Assistant Surgeon (when qualified resident surgeon not available)</td></tr><tr><td style="white-space:nowrap">90<a name="procedure-modifier-90"> </a></td><td>Reference (outside) lab</td><td>Reference (outside) laboratory</td></tr><tr><td style="white-space:nowrap">91<a name="procedure-modifier-91"> </a></td><td>Repeat dxtic lab test</td><td>Repeat clinical diagnostic laboratory test</td></tr><tr><td style="white-space:nowrap">92<a name="procedure-modifier-92"> </a></td><td>Alt lab platform testing</td><td>Alternative laboratory platform testing</td></tr><tr><td style="white-space:nowrap">95<a name="procedure-modifier-95"> </a></td><td>Synch telemedicine svc</td><td>Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system</td></tr><tr><td style="white-space:nowrap">96<a name="procedure-modifier-96"> </a></td><td>Habilitative Services</td><td>Habilitative Services</td></tr><tr><td style="white-space:nowrap">97<a name="procedure-modifier-97"> </a></td><td>Rehabilitative Services</td><td>Rehabilitative Services</td></tr><tr><td style="white-space:nowrap">99<a name="procedure-modifier-99"> </a></td><td>Multiple modifiers</td><td>Multiple modifiers</td></tr></table></div>
  </text>
  <url
       value="http://linuxforhealth.org/fhir/cdm/CodeSystem/procedure-modifier"/>
  <version value="8.0.0"/>
  <name value="ProcedureModifierCodeSystem"/>
  <title value="Procedure Modifier Codes"/>
  <status value="active"/>
  <date value="2022-11-10T16:00:46+00:00"/>
  <publisher value="LinuxForHealth Team"/>
  <description value="Codes indicating the procedure modifiers"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="473"/>
  <concept>
    <code value="1P"/>
    <display value="PM excl-med reasons"/>
    <definition value="Performance measure exclusion-medical reasons"/>
  </concept>
  <concept>
    <code value="2P"/>
    <display value="PM excl-pt reasons"/>
    <definition value="Performance measure exclusion-patient reasons"/>
  </concept>
  <concept>
    <code value="3P"/>
    <display value="PM excl-system reason"/>
    <definition value="Performance measure exclusion-system reasons"/>
  </concept>
  <concept>
    <code value="A1"/>
    <display value="Dressing for one wound"/>
  </concept>
  <concept>
    <code value="A2"/>
    <display value="Dressing for two wounds"/>
  </concept>
  <concept>
    <code value="A3"/>
    <display value="Dressing for three wounds"/>
  </concept>
  <concept>
    <code value="A4"/>
    <display value="Dressing for four wounds"/>
  </concept>
  <concept>
    <code value="A5"/>
    <display value="Dressing for five wounds"/>
  </concept>
  <concept>
    <code value="A6"/>
    <display value="Dressing for six wounds"/>
  </concept>
  <concept>
    <code value="A7"/>
    <display value="Dressing for seven wounds"/>
  </concept>
  <concept>
    <code value="A8"/>
    <display value="Dressing for eight wounds"/>
  </concept>
  <concept>
    <code value="A9"/>
    <display value="Dressing for nine or more wounds"/>
  </concept>
  <concept>
    <code value="AA"/>
    <display
             value="Anesthesia services performed personally by anesthesiologist"/>
  </concept>
  <concept>
    <code value="AD"/>
    <display
             value="Medical supervision by a physician: more than four concurrent anesthesia procedures"/>
  </concept>
  <concept>
    <code value="AE"/>
    <display value="Registered dietician"/>
  </concept>
  <concept>
    <code value="AF"/>
    <display value="Specialty physician"/>
  </concept>
  <concept>
    <code value="AG"/>
    <display value="Primary physician"/>
  </concept>
  <concept>
    <code value="AH"/>
    <display value="Clinical psychologist"/>
  </concept>
  <concept>
    <code value="AI"/>
    <display value="Principal physician of record"/>
  </concept>
  <concept>
    <code value="AJ"/>
    <display value="Clinical social worker"/>
  </concept>
  <concept>
    <code value="AK"/>
    <display value="Non participating physician"/>
  </concept>
  <concept>
    <code value="AM"/>
    <display value="Physician, team member service"/>
  </concept>
  <concept>
    <code value="AO"/>
    <display
             value="Alternate payment method declined by provider of service"/>
  </concept>
  <concept>
    <code value="AP"/>
    <display
             value="Determination of refractive state was not performed in the course of diagnostic ophthalmological examination"/>
  </concept>
  <concept>
    <code value="AQ"/>
    <display
             value="Physician providing a service in an unlisted health professional shortage area (hpsa)"/>
  </concept>
  <concept>
    <code value="AR"/>
    <display
             value="Physician provider services in a physician scarcity area"/>
  </concept>
  <concept>
    <code value="AS"/>
    <display
             value="Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery"/>
  </concept>
  <concept>
    <code value="AT"/>
    <display
             value="Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)"/>
  </concept>
  <concept>
    <code value="AU"/>
    <display
             value="Item furnished in conjunction with a urological, ostomy, or tracheostomy supply"/>
  </concept>
  <concept>
    <code value="AV"/>
    <display
             value="Item furnished in conjunction with a prosthetic device, prosthetic or orthotic"/>
  </concept>
  <concept>
    <code value="AW"/>
    <display value="Item furnished in conjunction with a surgical dressing"/>
  </concept>
  <concept>
    <code value="AX"/>
    <display value="Item furnished in conjunction with dialysis services"/>
  </concept>
  <concept>
    <code value="AY"/>
    <display
             value="Item or service furnished to an esrd patient that is not for the treatment of esrd"/>
  </concept>
  <concept>
    <code value="AZ"/>
    <display
             value="Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment"/>
  </concept>
  <concept>
    <code value="BA"/>
    <display
             value="Item furnished in conjunction with parenteral enteral nutrition (pen) services"/>
  </concept>
  <concept>
    <code value="BL"/>
    <display value="Special acquisition of blood and blood products"/>
  </concept>
  <concept>
    <code value="BO"/>
    <display value="Orally administered nutrition, not by feeding tube"/>
  </concept>
  <concept>
    <code value="BP"/>
    <display
             value="The beneficiary has been informed of the purchase and rental options and has elected to purchase the item"/>
  </concept>
  <concept>
    <code value="BR"/>
    <display
             value="The beneficiary has been informed of the purchase and rental options and has elected to rent the item"/>
  </concept>
  <concept>
    <code value="BU"/>
    <display
             value="The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision"/>
  </concept>
  <concept>
    <code value="CA"/>
    <display
             value="Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission"/>
  </concept>
  <concept>
    <code value="CB"/>
    <display
             value="Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable"/>
  </concept>
  <concept>
    <code value="CC"/>
    <display
             value="Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)"/>
  </concept>
  <concept>
    <code value="CD"/>
    <display
             value="Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable"/>
  </concept>
  <concept>
    <code value="CE"/>
    <display
             value="Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal * frequency covered under the rate and is separately reimbursable based on medical necessity"/>
  </concept>
  <concept>
    <code value="CF"/>
    <display
             value="Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable"/>
  </concept>
  <concept>
    <code value="CG"/>
    <display value="Policy criteria applied"/>
  </concept>
  <concept>
    <code value="CH"/>
    <display value="0 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CI"/>
    <display
             value="At least 1 percent but less than 20 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CJ"/>
    <display
             value="At least 20 percent but less than 40 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CK"/>
    <display
             value="At least 40 percent but less than 60 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CL"/>
    <display
             value="At least 60 percent but less than 80 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CM"/>
    <display
             value="At least 80 percent but less than 100 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CN"/>
    <display value="100 percent impaired, limited or restricted"/>
  </concept>
  <concept>
    <code value="CO"/>
    <display
             value="Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant"/>
  </concept>
  <concept>
    <code value="CP"/>
    <display
             value="Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure, but reported on a different claim"/>
  </concept>
  <concept>
    <code value="CQ"/>
    <display
             value="Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant"/>
  </concept>
  <concept>
    <code value="CR"/>
    <display value="Catastrophe/disaster related"/>
  </concept>
  <concept>
    <code value="CS"/>
    <display
             value="Item or service related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the gulf of mexico, including but not limited to subsequent clean-up activities"/>
  </concept>
  <concept>
    <code value="CT"/>
    <display
             value="Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard"/>
  </concept>
  <concept>
    <code value="DA"/>
    <display
             value="Oral health assessment by a licensed health professional other than a dentist"/>
  </concept>
  <concept>
    <code value="DD"/>
    <display value="AMB-site NEC to site NEC"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H  to diagnostic or therapeutic site other than P or H"/>
  </concept>
  <concept>
    <code value="DE"/>
    <display value="AMB-site NEC to RES fac"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to residential"/>
  </concept>
  <concept>
    <code value="DG"/>
    <display value="AMB-site NEC-hosp ESRD"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to hospital-based ESRD facility"/>
  </concept>
  <concept>
    <code value="DH"/>
    <display value="AMB-site NEC to hosp"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to hospital"/>
  </concept>
  <concept>
    <code value="DI"/>
    <display value="AMB-site NEC-transf site"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to site of transfer"/>
  </concept>
  <concept>
    <code value="DJ"/>
    <display value="AMB-NEC-Free stand ESRD"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to free standing ESRD facility"/>
  </concept>
  <concept>
    <code value="DN"/>
    <display value="AMB-site NEC to SNF"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to skilled nursing facility (SNF)"/>
  </concept>
  <concept>
    <code value="DP"/>
    <display value="AMB-site NEC to OV"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to physician's office"/>
  </concept>
  <concept>
    <code value="DR"/>
    <display value="AMB-site NEC to home"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to residence"/>
  </concept>
  <concept>
    <code value="DS"/>
    <display value="AMB-site NEC to accident"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to scene of accident or acute event"/>
  </concept>
  <concept>
    <code value="DX"/>
    <display value="AMB-site NEC to hosp+OV"/>
    <definition
                value="Ambulance service from diagnostic or therapeutic site other than P or H to hospital with intermediate stop at physician's office"/>
  </concept>
  <concept>
    <code value="E1"/>
    <display value="Upper left, eyelid"/>
  </concept>
  <concept>
    <code value="E2"/>
    <display value="Lower left, eyelid"/>
  </concept>
  <concept>
    <code value="E3"/>
    <display value="Upper right, eyelid"/>
  </concept>
  <concept>
    <code value="E4"/>
    <display value="Lower right, eyelid"/>
  </concept>
  <concept>
    <code value="EA"/>
    <display
             value="Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy"/>
  </concept>
  <concept>
    <code value="EB"/>
    <display
             value="Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy"/>
  </concept>
  <concept>
    <code value="EC"/>
    <display
             value="Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy"/>
  </concept>
  <concept>
    <code value="ED"/>
    <display
             value="Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle"/>
  </concept>
  <concept>
    <code value="EE"/>
    <display
             value="Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle"/>
  </concept>
  <concept>
    <code value="EG"/>
    <display value="AMB-RES fac-hosp ESRD"/>
    <definition
                value="Ambulance from RES facility to hosp-based ESRD facility"/>
  </concept>
  <concept>
    <code value="EH"/>
    <display value="AMB-RES facility to hosp"/>
    <definition value="Ambulance from residential facility to hospital"/>
  </concept>
  <concept>
    <code value="EI"/>
    <display value="AMB-RES fac-transf site"/>
    <definition
                value="Ambulance from residential fac to AMB mode transf site"/>
  </concept>
  <concept>
    <code value="EJ"/>
    <display
             value="Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab"/>
  </concept>
  <concept>
    <code value="EM"/>
    <display value="Emergency reserve supply (for esrd benefit only)"/>
  </concept>
  <concept>
    <code value="EN"/>
    <display value="AMB-RES facility to SNF"/>
    <definition value="Ambulance service from residential"/>
  </concept>
  <concept>
    <code value="EP"/>
    <display
             value="Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program"/>
  </concept>
  <concept>
    <code value="ER"/>
    <display
             value="Items and services furnished by a provider-based, off-campus emergency department"/>
  </concept>
  <concept>
    <code value="ES"/>
    <display value="AMB-RES fac to accident"/>
    <definition
                value="Ambulance from residential facility to accident scene"/>
  </concept>
  <concept>
    <code value="ET"/>
    <display value="Emergency services"/>
  </concept>
  <concept>
    <code value="EX"/>
    <display value="Expatriate beneficiary"/>
  </concept>
  <concept>
    <code value="EY"/>
    <display
             value="No physician or other licensed health care provider order for this item or service"/>
  </concept>
  <concept>
    <code value="F1"/>
    <display value="Left hand, second digit"/>
  </concept>
  <concept>
    <code value="F2"/>
    <display value="Left hand, third digit"/>
  </concept>
  <concept>
    <code value="F3"/>
    <display value="Left hand, fourth digit"/>
  </concept>
  <concept>
    <code value="F4"/>
    <display value="Left hand, fifth digit"/>
  </concept>
  <concept>
    <code value="F5"/>
    <display value="Right hand, thumb"/>
  </concept>
  <concept>
    <code value="F6"/>
    <display value="Right hand, second digit"/>
  </concept>
  <concept>
    <code value="F7"/>
    <display value="Right hand, third digit"/>
  </concept>
  <concept>
    <code value="F8"/>
    <display value="Right hand, fourth digit"/>
  </concept>
  <concept>
    <code value="F9"/>
    <display value="Right hand, fifth digit"/>
  </concept>
  <concept>
    <code value="FA"/>
    <display value="Left hand, thumb"/>
  </concept>
  <concept>
    <code value="FB"/>
    <display
             value="Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)"/>
  </concept>
  <concept>
    <code value="FC"/>
    <display value="Partial credit received for replaced device"/>
  </concept>
  <concept>
    <code value="FP"/>
    <display value="Service provided as part of family planning program"/>
  </concept>
  <concept>
    <code value="FX"/>
    <display value="X-ray taken using film"/>
  </concept>
  <concept>
    <code value="FY"/>
    <display
             value="X-ray taken using computed radiography technology/cassette-based imaging"/>
  </concept>
  <concept>
    <code value="G0"/>
    <display
             value="Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke"/>
  </concept>
  <concept>
    <code value="G1"/>
    <display value="Most recent urr reading of less than 60"/>
  </concept>
  <concept>
    <code value="G2"/>
    <display value="Most recent urr reading of 60 to 64.9"/>
  </concept>
  <concept>
    <code value="G3"/>
    <display value="Most recent urr reading of 65 to 69.9"/>
  </concept>
  <concept>
    <code value="G4"/>
    <display value="Most recent urr reading of 70 to 74.9"/>
  </concept>
  <concept>
    <code value="G5"/>
    <display value="Most recent urr reading of 75 or greater"/>
  </concept>
  <concept>
    <code value="G6"/>
    <display
             value="Esrd patient for whom less than six dialysis sessions have been provided in a month"/>
  </concept>
  <concept>
    <code value="G7"/>
    <display
             value="Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening"/>
  </concept>
  <concept>
    <code value="G8"/>
    <display
             value="Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure"/>
  </concept>
  <concept>
    <code value="G9"/>
    <display
             value="Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition"/>
  </concept>
  <concept>
    <code value="GA"/>
    <display
             value="Waiver of liability statement issued as required by payer policy, individual case"/>
  </concept>
  <concept>
    <code value="GB"/>
    <display
             value="Claim being re-submitted for payment because it is no longer covered under a global payment demonstration"/>
  </concept>
  <concept>
    <code value="GC"/>
    <display
             value="This service has been performed in part by a resident under the direction of a teaching physician"/>
  </concept>
  <concept>
    <code value="GD"/>
    <display
             value="Units of service exceeds medically unlikely edit value and represents reasonable and necessary services"/>
  </concept>
  <concept>
    <code value="GE"/>
    <display
             value="This service has been performed by a resident without the presence of a teaching physician under the primary care exception"/>
  </concept>
  <concept>
    <code value="GF"/>
    <display
             value="Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital"/>
  </concept>
  <concept>
    <code value="GG"/>
    <display
             value="Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day"/>
  </concept>
  <concept>
    <code value="GH"/>
    <display
             value="Diagnostic mammogram converted from screening mammogram on same day"/>
  </concept>
  <concept>
    <code value="GI"/>
    <display value="AMB-hosp ESRD-transfer"/>
    <definition
                value="Ambulance from hosp-based ESRD facility to ambulance mode transfer"/>
  </concept>
  <concept>
    <code value="GJ"/>
    <display value="Opt out emerg svc"/>
    <definition
                value="Opt out physician or practitioner emergency or urgent service"/>
  </concept>
  <concept>
    <code value="GK"/>
    <display
             value="Reasonable and necessary item/service associated with a ga or gz modifier"/>
  </concept>
  <concept>
    <code value="GL"/>
    <display
             value="Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)"/>
  </concept>
  <concept>
    <code value="GM"/>
    <display value="Multiple patients on one ambulance trip"/>
  </concept>
  <concept>
    <code value="GN"/>
    <display
             value="Services delivered under an outpatient speech language pathology plan of care"/>
  </concept>
  <concept>
    <code value="GO"/>
    <display
             value="Services delivered under an outpatient occupational therapy plan of care"/>
  </concept>
  <concept>
    <code value="GP"/>
    <display
             value="Services delivered under an outpatient physical therapy plan of care"/>
  </concept>
  <concept>
    <code value="GQ"/>
    <display value="Via asynchronous telecommunications system"/>
  </concept>
  <concept>
    <code value="GR"/>
    <display
             value="This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy"/>
  </concept>
  <concept>
    <code value="GS"/>
    <display
             value="Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level"/>
  </concept>
  <concept>
    <code value="GT"/>
    <display
             value="Via interactive audio and video telecommunication systems"/>
  </concept>
  <concept>
    <code value="GU"/>
    <display
             value="Waiver of liability statement issued as required by payer policy, routine notice"/>
  </concept>
  <concept>
    <code value="GV"/>
    <display
             value="Attending physician not employed or paid under arrangement by the patient's hospice provider"/>
  </concept>
  <concept>
    <code value="GW"/>
    <display
             value="Service not related to the hospice patient's terminal condition"/>
  </concept>
  <concept>
    <code value="GX"/>
    <display
             value="Notice of liability issued, voluntary under payer policy"/>
  </concept>
  <concept>
    <code value="GY"/>
    <display
             value="Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"/>
  </concept>
  <concept>
    <code value="GZ"/>
    <display
             value="Item or service expected to be denied as not reasonable and necessary"/>
  </concept>
  <concept>
    <code value="H9"/>
    <display value="Court-ordered"/>
  </concept>
  <concept>
    <code value="HA"/>
    <display value="Child/adolescent program"/>
  </concept>
  <concept>
    <code value="HB"/>
    <display value="Adult program, non geriatric"/>
  </concept>
  <concept>
    <code value="HC"/>
    <display value="Adult program, geriatric"/>
  </concept>
  <concept>
    <code value="HD"/>
    <display value="Pregnant/parenting women's program"/>
  </concept>
  <concept>
    <code value="HE"/>
    <display value="Mental health program"/>
  </concept>
  <concept>
    <code value="HF"/>
    <display value="Substance abuse program"/>
  </concept>
  <concept>
    <code value="HG"/>
    <display value="Opioid addiction treatment program"/>
  </concept>
  <concept>
    <code value="HH"/>
    <display value="Integrated mental health/substance abuse program"/>
  </concept>
  <concept>
    <code value="HI"/>
    <display
             value="Integrated mental health and intellectual disability/developmental disabilities program"/>
  </concept>
  <concept>
    <code value="HJ"/>
    <display value="Employee assistance program"/>
  </concept>
  <concept>
    <code value="HK"/>
    <display
             value="Specialized mental health programs for high-risk populations"/>
  </concept>
  <concept>
    <code value="HL"/>
    <display value="Intern"/>
  </concept>
  <concept>
    <code value="HM"/>
    <display value="Less than bachelor degree level"/>
  </concept>
  <concept>
    <code value="HN"/>
    <display value="Bachelors degree level"/>
  </concept>
  <concept>
    <code value="HO"/>
    <display value="Masters degree level"/>
  </concept>
  <concept>
    <code value="HP"/>
    <display value="Doctoral level"/>
  </concept>
  <concept>
    <code value="HQ"/>
    <display value="Group setting"/>
  </concept>
  <concept>
    <code value="HR"/>
    <display value="Family/couple with client present"/>
  </concept>
  <concept>
    <code value="HS"/>
    <display value="Family/couple without client present"/>
  </concept>
  <concept>
    <code value="HT"/>
    <display value="Multi-disciplinary team"/>
  </concept>
  <concept>
    <code value="HU"/>
    <display value="Funded by child welfare agency"/>
  </concept>
  <concept>
    <code value="HV"/>
    <display value="Funded state addictions agency"/>
  </concept>
  <concept>
    <code value="HW"/>
    <display value="Funded by state mental health agency"/>
  </concept>
  <concept>
    <code value="HX"/>
    <display value="Funded by county/local agency"/>
  </concept>
  <concept>
    <code value="HY"/>
    <display value="Funded by juvenile justice agency"/>
  </concept>
  <concept>
    <code value="HZ"/>
    <display value="Funded by criminal justice agency"/>
  </concept>
  <concept>
    <code value="ID"/>
    <display value="AMB-transf site to NEC"/>
    <definition
                value="Ambulance service from AMB mode transfer site to diagnostic or therapeutic site NEC"/>
  </concept>
  <concept>
    <code value="IE"/>
    <display value="AMB-transf site to RES"/>
    <definition
                value="Ambulance service from AMB mode transfer site to RES facility"/>
  </concept>
  <concept>
    <code value="IG"/>
    <display value="AMB-transf site-ESRD"/>
    <definition
                value="Ambulance service from AMB mode transf site to hosp ESRD facility"/>
  </concept>
  <concept>
    <code value="IH"/>
    <display value="AMB-transf site to hosp"/>
    <definition
                value="Ambulance service from AMB mode transfer site to hospital"/>
  </concept>
  <concept>
    <code value="II"/>
    <display value="AMB-transf site-transf"/>
    <definition
                value="Ambulance service from AMB mode transf site to AMB mode transfer"/>
  </concept>
  <concept>
    <code value="IJ"/>
    <display value="AMB-transf site-FS ESRD"/>
    <definition
                value="Ambulance service from AMB mode transf site to free stand ESRD facility"/>
  </concept>
  <concept>
    <code value="IN"/>
    <display value="AMB-transf site to SNF"/>
    <definition value="Ambulance service from AMB mode transfer site to SNF"/>
  </concept>
  <concept>
    <code value="IP"/>
    <display value="AMB-transf site to OV"/>
    <definition
                value="Ambulance service from AMB mode transfer site to phys office"/>
  </concept>
  <concept>
    <code value="IR"/>
    <display value="AMB-transf site to home"/>
    <definition
                value="Ambulance service from AMB mode transfer site to residence"/>
  </concept>
  <concept>
    <code value="IS"/>
    <display value="AMB-transf site to accid"/>
    <definition
                value="Ambulance service from transfer site to accident scene"/>
  </concept>
  <concept>
    <code value="IX"/>
    <display value="AMB-transf site-OV/hosp"/>
    <definition
                value="Ambulance service from AMB mode transf site to OV/hospital"/>
  </concept>
  <concept>
    <code value="J1"/>
    <display
             value="Competitive acquisition program no-pay submission for a prescription number"/>
  </concept>
  <concept>
    <code value="J2"/>
    <display
             value="Competitive acquisition program, restocking of emergency drugs after emergency administration"/>
  </concept>
  <concept>
    <code value="J3"/>
    <display
             value="Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology"/>
  </concept>
  <concept>
    <code value="J4"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge"/>
  </concept>
  <concept>
    <code value="JA"/>
    <display value="Administered intravenously"/>
  </concept>
  <concept>
    <code value="JB"/>
    <display value="Administered subcutaneously"/>
  </concept>
  <concept>
    <code value="JC"/>
    <display value="Skin substitute used as a graft"/>
  </concept>
  <concept>
    <code value="JD"/>
    <display value="Skin substitute not used as a graft"/>
  </concept>
  <concept>
    <code value="JE"/>
    <display value="Administered via dialysate"/>
  </concept>
  <concept>
    <code value="JF"/>
    <display value="Compounded drug"/>
  </concept>
  <concept>
    <code value="JG"/>
    <display
             value="Drug or biological acquired with 340b drug pricing program discount"/>
  </concept>
  <concept>
    <code value="JH"/>
    <display value="AMB-free stand ESRD-hosp"/>
    <definition
                value="Ambulance service from free standing ESRD facility to hospital"/>
  </concept>
  <concept>
    <code value="JI"/>
    <display value="AMB-FS ESRD-transf site"/>
    <definition
                value="Ambulance service from free standing ESRD fac to AMB transf site"/>
  </concept>
  <concept>
    <code value="JJ"/>
    <display value="AMB-free stand ESRD-same"/>
    <definition
                value="Ambulance service from free standing ESRD facility to free standing ESRD facility"/>
  </concept>
  <concept>
    <code value="JN"/>
    <display value="AMB-free stand ESRD-SNF"/>
    <definition
                value="Ambulance service from free standing ESRD facility to skilled nursing facility (SNF)"/>
  </concept>
  <concept>
    <code value="JP"/>
    <display value="AMB-free stand ESRD-OV"/>
    <definition
                value="Ambulance service from free standing ESRD facility to physician's office"/>
  </concept>
  <concept>
    <code value="JR"/>
    <display value="AMB-free stand ESRD-home"/>
    <definition
                value="Ambulance service from free standing ESRD facility to residence"/>
  </concept>
  <concept>
    <code value="JS"/>
    <display value="AMB-FS ESRD to accident"/>
    <definition
                value="Ambulance service from free standing ESRD facility to scene of accident or acute event"/>
  </concept>
  <concept>
    <code value="JW"/>
    <display value="Drug amount discarded/not administered to any patient"/>
  </concept>
  <concept>
    <code value="JX"/>
    <display value="AMB-FS ESRD-hosp w OV"/>
    <definition
                value="Ambulance service from free standing ESRD facility to hospital with intermediate stop at physician's office"/>
  </concept>
  <concept>
    <code value="K0"/>
    <display
             value="Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility."/>
  </concept>
  <concept>
    <code value="K1"/>
    <display
             value="Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator."/>
  </concept>
  <concept>
    <code value="K2"/>
    <display
             value="Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces.  typical of the limited community ambulator."/>
  </concept>
  <concept>
    <code value="K3"/>
    <display
             value="Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence.  typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion."/>
  </concept>
  <concept>
    <code value="K4"/>
    <display
             value="Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete."/>
  </concept>
  <concept>
    <code value="KA"/>
    <display value="Add on option/accessory for wheelchair"/>
  </concept>
  <concept>
    <code value="KB"/>
    <display
             value="Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim"/>
  </concept>
  <concept>
    <code value="KC"/>
    <display value="Replacement of special power wheelchair interface"/>
  </concept>
  <concept>
    <code value="KD"/>
    <display value="Drug or biological infused through dme"/>
  </concept>
  <concept>
    <code value="KE"/>
    <display
             value="Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment"/>
  </concept>
  <concept>
    <code value="KF"/>
    <display value="Item designated by fda as class iii device"/>
  </concept>
  <concept>
    <code value="KG"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program number 1"/>
  </concept>
  <concept>
    <code value="KH"/>
    <display
             value="Dmepos item, initial claim, purchase or first month rental"/>
  </concept>
  <concept>
    <code value="KI"/>
    <display value="Dmepos item, second or third month rental"/>
  </concept>
  <concept>
    <code value="KJ"/>
    <display
             value="Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen"/>
  </concept>
  <concept>
    <code value="KK"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program number 2"/>
  </concept>
  <concept>
    <code value="KL"/>
    <display value="Dmepos item delivered via mail"/>
  </concept>
  <concept>
    <code value="KM"/>
    <display
             value="Replacement of facial prosthesis including new impression/moulage"/>
  </concept>
  <concept>
    <code value="KN"/>
    <display
             value="Replacement of facial prosthesis using previous master model"/>
  </concept>
  <concept>
    <code value="KO"/>
    <display value="Single drug unit dose formulation"/>
  </concept>
  <concept>
    <code value="KP"/>
    <display value="First drug of a multiple drug unit dose formulation"/>
  </concept>
  <concept>
    <code value="KQ"/>
    <display
             value="Second or subsequent drug of a multiple drug unit dose formulation"/>
  </concept>
  <concept>
    <code value="KR"/>
    <display value="Rental item, billing for partial month"/>
  </concept>
  <concept>
    <code value="KS"/>
    <display
             value="Glucose monitor supply for diabetic beneficiary not treated with insulin"/>
  </concept>
  <concept>
    <code value="KT"/>
    <display
             value="Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item"/>
  </concept>
  <concept>
    <code value="KU"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program number 3"/>
  </concept>
  <concept>
    <code value="KV"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service"/>
  </concept>
  <concept>
    <code value="KW"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program number 4"/>
  </concept>
  <concept>
    <code value="KX"/>
    <display
             value="Requirements specified in the medical policy have been met"/>
  </concept>
  <concept>
    <code value="KY"/>
    <display
             value="Dmepos item subject to dmepos competitive bidding program number 5"/>
  </concept>
  <concept>
    <code value="KZ"/>
    <display value="New coverage not implemented by managed care"/>
  </concept>
  <concept>
    <code value="L1"/>
    <display
             value="Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps"/>
  </concept>
  <concept>
    <code value="LC"/>
    <display value="Left circumflex coronary artery"/>
  </concept>
  <concept>
    <code value="LD"/>
    <display value="Left anterior descending coronary artery"/>
  </concept>
  <concept>
    <code value="LL"/>
    <display
             value="Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)"/>
  </concept>
  <concept>
    <code value="LM"/>
    <display value="Left main coronary artery"/>
  </concept>
  <concept>
    <code value="LR"/>
    <display value="Laboratory round trip"/>
  </concept>
  <concept>
    <code value="LS"/>
    <display value="Fda-monitored intraocular lens implant"/>
  </concept>
  <concept>
    <code value="LT"/>
    <display
             value="Left side (used to identify procedures performed on the left side of the body)"/>
  </concept>
  <concept>
    <code value="M2"/>
    <display value="Medicare secondary payer (msp)"/>
  </concept>
  <concept>
    <code value="MA"/>
    <display
             value="Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition"/>
  </concept>
  <concept>
    <code value="MB"/>
    <display
             value="Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access"/>
  </concept>
  <concept>
    <code value="MC"/>
    <display
             value="Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues"/>
  </concept>
  <concept>
    <code value="MD"/>
    <display
             value="Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances"/>
  </concept>
  <concept>
    <code value="ME"/>
    <display
             value="The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional"/>
  </concept>
  <concept>
    <code value="MF"/>
    <display
             value="The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional"/>
  </concept>
  <concept>
    <code value="MG"/>
    <display
             value="The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional"/>
  </concept>
  <concept>
    <code value="MH"/>
    <display
             value="Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider"/>
  </concept>
  <concept>
    <code value="MS"/>
    <display
             value="Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty"/>
  </concept>
  <concept>
    <code value="NB"/>
    <display
             value="Nebulizer system, any type, fda-cleared for use with specific drug"/>
  </concept>
  <concept>
    <code value="ND"/>
    <display value="AMB-SNF to site NEC"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to diagnostic or therapeutic site other than P or H"/>
  </concept>
  <concept>
    <code value="NE"/>
    <display value="AMB-SNF to RES facility"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to residential facility"/>
  </concept>
  <concept>
    <code value="NG"/>
    <display value="AMB-SNF to hosp ESRD"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to a hospital-based ESRD facility"/>
  </concept>
  <concept>
    <code value="NH"/>
    <display
             value="AMB-SNF to hosp|Ambulance from skilled nursing facility to hosp|Ambulance service from skilled nursing facility (SNF) to hospital"/>
  </concept>
  <concept>
    <code value="NI"/>
    <display value="AMB-SNF to transf site"/>
    <definition value="Ambulance service from SNF to AMB mode transfer site"/>
  </concept>
  <concept>
    <code value="NJ"/>
    <display value="AMB-SNF-free stand ESRD"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to a free standing ESRD facility"/>
  </concept>
  <concept>
    <code value="NN"/>
    <display value="Ambulance-SNF to SNF"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to skilled nursing facility (SNF)"/>
  </concept>
  <concept>
    <code value="NP"/>
    <display value="AMB-SNF to phys office"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to physician's office"/>
  </concept>
  <concept>
    <code value="NR"/>
    <display
             value="New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)"/>
  </concept>
  <concept>
    <code value="NS"/>
    <display value="AMB-SNF to accident"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to scene of accident or acute event"/>
  </concept>
  <concept>
    <code value="NU"/>
    <display value="New equipment"/>
  </concept>
  <concept>
    <code value="NX"/>
    <display value="AMB-SNF to hosp w OV"/>
    <definition
                value="Ambulance service from skilled nursing facility (SNF) to hospital with intermediate stop at physician's office"/>
  </concept>
  <concept>
    <code value="P1"/>
    <display value="A normal healthy patient"/>
  </concept>
  <concept>
    <code value="P2"/>
    <display value="A patient with mild systemic disease"/>
  </concept>
  <concept>
    <code value="P3"/>
    <display value="A patient with severe systemic disease"/>
  </concept>
  <concept>
    <code value="P4"/>
    <display
             value="A patient with severe systemic disease that is a constant threat to life"/>
  </concept>
  <concept>
    <code value="P5"/>
    <display
             value="A moribund patient who is not expected to survive without the operation"/>
  </concept>
  <concept>
    <code value="P6"/>
    <display
             value="A declared brain-dead patient whose organs are being removed for donor purposes"/>
  </concept>
  <concept>
    <code value="PA"/>
    <display value="Surgical or other invasive procedure on wrong body part"/>
  </concept>
  <concept>
    <code value="PB"/>
    <display value="Surgical or other invasive procedure on wrong patient"/>
  </concept>
  <concept>
    <code value="PC"/>
    <display value="Wrong surgery or other invasive procedure on patient"/>
  </concept>
  <concept>
    <code value="PD"/>
    <display
             value="Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days"/>
  </concept>
  <concept>
    <code value="PE"/>
    <display value="AMB-OV to RES fac"/>
    <definition
                value="Ambulance service from physician's office to residential facility"/>
  </concept>
  <concept>
    <code value="PG"/>
    <display value="AMB-OV to hosp ESRD"/>
    <definition
                value="Ambulance service from physician's office to a hospital-based ESRD facility"/>
  </concept>
  <concept>
    <code value="PH"/>
    <display value="AMB-phys office to hosp"/>
    <definition
                value="Ambulance service from physician's office to hospital"/>
  </concept>
  <concept>
    <code value="PI"/>
    <display
             value="Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing"/>
  </concept>
  <concept>
    <code value="PJ"/>
    <display value="AMB-OV to FS ESRD"/>
    <definition
                value="Ambulance service from physician's office to free standing ESRD facility"/>
  </concept>
  <concept>
    <code value="PL"/>
    <display value="Progressive addition lenses"/>
  </concept>
  <concept>
    <code value="PM"/>
    <display value="Post mortem"/>
  </concept>
  <concept>
    <code value="PN"/>
    <display
             value="Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital"/>
  </concept>
  <concept>
    <code value="PO"/>
    <display
             value="Excepted service provided at an off-campus, outpatient, provider-based department of a hospital"/>
  </concept>
  <concept>
    <code value="PR"/>
    <display value="AMB-phys office to home"/>
    <definition
                value="Ambulance service from physician's office to residence"/>
  </concept>
  <concept>
    <code value="PS"/>
    <display
             value="Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy"/>
  </concept>
  <concept>
    <code value="PT"/>
    <display
             value="Colorectal cancer screening test; converted to diagnostic test or other procedure"/>
  </concept>
  <concept>
    <code value="PX"/>
    <display value="AMB-OV to hosp+OV"/>
    <definition
                value="Ambulance service from physician's office to hospital with intermediate stop at physician's office"/>
  </concept>
  <concept>
    <code value="Q0"/>
    <display
             value="Investigational clinical service provided in a clinical research study that is in an approved clinical research study"/>
  </concept>
  <concept>
    <code value="Q1"/>
    <display
             value="Routine clinical service provided in a clinical research study that is in an approved clinical research study"/>
  </concept>
  <concept>
    <code value="Q2"/>
    <display value="Demonstration procedure/service"/>
  </concept>
  <concept>
    <code value="Q3"/>
    <display value="Live kidney donor surgery and related services"/>
  </concept>
  <concept>
    <code value="Q4"/>
    <display
             value="Service for ordering/referring physician qualifies as a service exemption"/>
  </concept>
  <concept>
    <code value="Q5"/>
    <display
             value="Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area"/>
  </concept>
  <concept>
    <code value="Q6"/>
    <display
             value="Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area"/>
  </concept>
  <concept>
    <code value="Q7"/>
    <display value="One class a finding"/>
  </concept>
  <concept>
    <code value="Q8"/>
    <display value="Two class b findings"/>
  </concept>
  <concept>
    <code value="Q9"/>
    <display value="One class b and two class c findings"/>
  </concept>
  <concept>
    <code value="QA"/>
    <display
             value="Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)"/>
  </concept>
  <concept>
    <code value="QB"/>
    <display
             value="Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed"/>
  </concept>
  <concept>
    <code value="QC"/>
    <display value="Single channel monitoring"/>
  </concept>
  <concept>
    <code value="QD"/>
    <display
             value="Recording and storage in solid state memory by a digital recorder"/>
  </concept>
  <concept>
    <code value="QE"/>
    <display
             value="Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)"/>
  </concept>
  <concept>
    <code value="QF"/>
    <display
             value="Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed"/>
  </concept>
  <concept>
    <code value="QG"/>
    <display
             value="Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)"/>
  </concept>
  <concept>
    <code value="QH"/>
    <display
             value="Oxygen conserving device is being used with an oxygen delivery system"/>
  </concept>
  <concept>
    <code value="QJ"/>
    <display
             value="Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)"/>
  </concept>
  <concept>
    <code value="QK"/>
    <display
             value="Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals"/>
  </concept>
  <concept>
    <code value="QL"/>
    <display value="Patient pronounced dead after ambulance called"/>
  </concept>
  <concept>
    <code value="QM"/>
    <display
             value="Ambulance service provided under arrangement by a provider of services"/>
  </concept>
  <concept>
    <code value="QN"/>
    <display
             value="Ambulance service furnished directly by a provider of services"/>
  </concept>
  <concept>
    <code value="QP"/>
    <display
             value="Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060."/>
  </concept>
  <concept>
    <code value="QQ"/>
    <display
             value="Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional"/>
  </concept>
  <concept>
    <code value="QR"/>
    <display
             value="Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)"/>
  </concept>
  <concept>
    <code value="QS"/>
    <display value="Monitored anesthesia care service"/>
  </concept>
  <concept>
    <code value="QT"/>
    <display
             value="Recording and storage on tape by an analog tape recorder"/>
  </concept>
  <concept>
    <code value="QW"/>
    <display value="Clia waived test"/>
  </concept>
  <concept>
    <code value="QX"/>
    <display value="Crna service: with medical direction by a physician"/>
  </concept>
  <concept>
    <code value="QY"/>
    <display
             value="Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist"/>
  </concept>
  <concept>
    <code value="QZ"/>
    <display value="Crna service: without medical direction by a physician"/>
  </concept>
  <concept>
    <code value="RA"/>
    <display value="Replacement of a dme, orthotic or prosthetic item"/>
  </concept>
  <concept>
    <code value="RB"/>
    <display
             value="Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair"/>
  </concept>
  <concept>
    <code value="RC"/>
    <display value="Right coronary artery"/>
  </concept>
  <concept>
    <code value="RD"/>
    <display
             value="Drug provided to beneficiary, but not administered incident-to"/>
  </concept>
  <concept>
    <code value="RE"/>
    <display
             value="Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)"/>
  </concept>
  <concept>
    <code value="RG"/>
    <display value="AMB-home to hosp ESRD"/>
    <definition
                value="Ambulance service from residence to hospital-based ESRD facility"/>
  </concept>
  <concept>
    <code value="RH"/>
    <display value="AMB-home to hosp"/>
    <definition value="Ambulance service from residence to hospital"/>
  </concept>
  <concept>
    <code value="RI"/>
    <display value="Ramus intermedius coronary artery"/>
  </concept>
  <concept>
    <code value="RJ"/>
    <display value="AMB-home-free stand ESRD"/>
    <definition
                value="Ambulance service from residence to free standing ESRD facility"/>
  </concept>
  <concept>
    <code value="RN"/>
    <display value="AMB-home to SNF"/>
    <definition
                value="Ambulance service from residence to skilled nursing facility (SNF)"/>
  </concept>
  <concept>
    <code value="RP"/>
    <display value="AMB-home to phys office"/>
    <definition
                value="Ambulance service from residence to physician's office"/>
  </concept>
  <concept>
    <code value="RR"/>
    <display value="Rental (use the 'rr' modifier when dme is to be rented)"/>
  </concept>
  <concept>
    <code value="RS"/>
    <display value="AMB-home to accident"/>
    <definition
                value="Ambulance service from residence to scene of accident or acute event"/>
  </concept>
  <concept>
    <code value="RT"/>
    <display
             value="Right side (used to identify procedures performed on the right side of the body)"/>
  </concept>
  <concept>
    <code value="RX"/>
    <display value="AMB-home to hosp w OV"/>
    <definition
                value="Ambulance service from residence to hospital with intermediate stop at physician's office"/>
  </concept>
  <concept>
    <code value="SA"/>
    <display
             value="Nurse practitioner rendering service in collaboration with a physician"/>
  </concept>
  <concept>
    <code value="SB"/>
    <display value="Nurse midwife"/>
  </concept>
  <concept>
    <code value="SC"/>
    <display value="Medically necessary service or supply"/>
  </concept>
  <concept>
    <code value="SD"/>
    <display
             value="Services provided by registered nurse with specialized, highly technical home infusion training"/>
  </concept>
  <concept>
    <code value="SE"/>
    <display value="State and/or federally-funded programs/services"/>
  </concept>
  <concept>
    <code value="SF"/>
    <display
             value="Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)"/>
  </concept>
  <concept>
    <code value="SG"/>
    <display value="Ambulatory surgical center (asc) facility service"/>
  </concept>
  <concept>
    <code value="SH"/>
    <display value="Second concurrently administered infusion therapy"/>
  </concept>
  <concept>
    <code value="SI"/>
    <display value="AMB-accident to transf"/>
    <definition
                value="Ambulance from accident scene to AMB mode transfer site"/>
  </concept>
  <concept>
    <code value="SJ"/>
    <display
             value="Third or more concurrently administered infusion therapy"/>
  </concept>
  <concept>
    <code value="SK"/>
    <display
             value="Member of high risk population (use only with codes for immunization)"/>
  </concept>
  <concept>
    <code value="SL"/>
    <display value="State supplied vaccine"/>
  </concept>
  <concept>
    <code value="SM"/>
    <display value="Second surgical opinion"/>
  </concept>
  <concept>
    <code value="SN"/>
    <display value="Third surgical opinion"/>
  </concept>
  <concept>
    <code value="SP"/>
    <display value="AMB-accident to OV"/>
    <definition
                value="Ambulance service from scene of accident or acute event to physician's office"/>
  </concept>
  <concept>
    <code value="SQ"/>
    <display value="Item ordered by home health"/>
  </concept>
  <concept>
    <code value="SR"/>
    <display value="AMB-accident to home"/>
    <definition
                value="Ambulance service from scene of accident or acute event to residence"/>
  </concept>
  <concept>
    <code value="SS"/>
    <display
             value="Home infusion services provided in the infusion suite of the iv therapy provider"/>
  </concept>
  <concept>
    <code value="ST"/>
    <display value="Related to trauma or injury"/>
  </concept>
  <concept>
    <code value="SU"/>
    <display
             value="Procedure performed in physician's office (to denote use of facility and equipment)"/>
  </concept>
  <concept>
    <code value="SV"/>
    <display
             value="Pharmaceuticals delivered to patient's home but not utilized"/>
  </concept>
  <concept>
    <code value="SW"/>
    <display value="Services provided by a certified diabetic educator"/>
  </concept>
  <concept>
    <code value="SX"/>
    <display value="AMB-accident to hosp+OV"/>
    <definition
                value="Ambulance service from scene of accident or acute event to hospital with intermediate stop at physician's office"/>
  </concept>
  <concept>
    <code value="SY"/>
    <display
             value="Persons who are in close contact with member of high-risk population (use only with codes for immunization)"/>
  </concept>
  <concept>
    <code value="SZ"/>
    <display value="Habilitative services"/>
  </concept>
  <concept>
    <code value="T1"/>
    <display value="Left foot, second digit"/>
  </concept>
  <concept>
    <code value="T2"/>
    <display value="Left foot, third digit"/>
  </concept>
  <concept>
    <code value="T3"/>
    <display value="Left foot, fourth digit"/>
  </concept>
  <concept>
    <code value="T4"/>
    <display value="Left foot, fifth digit"/>
  </concept>
  <concept>
    <code value="T5"/>
    <display value="Right foot, great toe"/>
  </concept>
  <concept>
    <code value="T6"/>
    <display value="Right foot, second digit"/>
  </concept>
  <concept>
    <code value="T7"/>
    <display value="Right foot, third digit"/>
  </concept>
  <concept>
    <code value="T8"/>
    <display value="Right foot, fourth digit"/>
  </concept>
  <concept>
    <code value="T9"/>
    <display value="Right foot, fifth digit"/>
  </concept>
  <concept>
    <code value="TA"/>
    <display value="Left foot, great toe"/>
  </concept>
  <concept>
    <code value="TB"/>
    <display
             value="Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes"/>
  </concept>
  <concept>
    <code value="TC"/>
    <display
             value="Technical component; under certain circumstances, a charge may be made for the technical component alone;  under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles"/>
  </concept>
  <concept>
    <code value="TD"/>
    <display value="Rn"/>
  </concept>
  <concept>
    <code value="TE"/>
    <display value="Lpn/lvn"/>
  </concept>
  <concept>
    <code value="TF"/>
    <display value="Intermediate level of care"/>
  </concept>
  <concept>
    <code value="TG"/>
    <display value="Complex/high tech level of care"/>
  </concept>
  <concept>
    <code value="TH"/>
    <display value="Obstetrical treatment/services, prenatal or postpartum"/>
  </concept>
  <concept>
    <code value="TJ"/>
    <display value="Program group, child and/or adolescent"/>
  </concept>
  <concept>
    <code value="TK"/>
    <display value="Extra patient or passenger, non-ambulance"/>
  </concept>
  <concept>
    <code value="TL"/>
    <display
             value="Early intervention/individualized family service plan (ifsp)"/>
  </concept>
  <concept>
    <code value="TM"/>
    <display value="Individualized education program (iep)"/>
  </concept>
  <concept>
    <code value="TN"/>
    <display value="Rural/outside providers' customary service area"/>
  </concept>
  <concept>
    <code value="TP"/>
    <display value="Medical transport, unloaded vehicle"/>
  </concept>
  <concept>
    <code value="TQ"/>
    <display
             value="Basic life support transport by a volunteer ambulance provider"/>
  </concept>
  <concept>
    <code value="TR"/>
    <display
             value="School-based individualized education program (iep) services provided outside the public school district responsible for the student"/>
  </concept>
  <concept>
    <code value="TS"/>
    <display value="Follow-up service"/>
  </concept>
  <concept>
    <code value="TT"/>
    <display
             value="Individualized service provided to more than one patient in same setting"/>
  </concept>
  <concept>
    <code value="TU"/>
    <display value="Special payment rate, overtime"/>
  </concept>
  <concept>
    <code value="TV"/>
    <display value="Special payment rates, holidays/weekends"/>
  </concept>
  <concept>
    <code value="TW"/>
    <display value="Back-up equipment"/>
  </concept>
  <concept>
    <code value="U1"/>
    <display value="Medicaid level of care 1, as defined by each state"/>
  </concept>
  <concept>
    <code value="U2"/>
    <display value="Medicaid level of care 2, as defined by each state"/>
  </concept>
  <concept>
    <code value="U3"/>
    <display value="Medicaid level of care 3, as defined by each state"/>
  </concept>
  <concept>
    <code value="U4"/>
    <display value="Medicaid level of care 4, as defined by each state"/>
  </concept>
  <concept>
    <code value="U5"/>
    <display value="Medicaid level of care 5, as defined by each state"/>
  </concept>
  <concept>
    <code value="U6"/>
    <display value="Medicaid level of care 6, as defined by each state"/>
  </concept>
  <concept>
    <code value="U7"/>
    <display value="Medicaid level of care 7, as defined by each state"/>
  </concept>
  <concept>
    <code value="U8"/>
    <display value="Medicaid level of care 8, as defined by each state"/>
  </concept>
  <concept>
    <code value="U9"/>
    <display value="Medicaid level of care 9, as defined by each state"/>
  </concept>
  <concept>
    <code value="UA"/>
    <display value="Medicaid level of care 10, as defined by each state"/>
  </concept>
  <concept>
    <code value="UB"/>
    <display value="Medicaid level of care 11, as defined by each state"/>
  </concept>
  <concept>
    <code value="UC"/>
    <display value="Medicaid level of care 12, as defined by each state"/>
  </concept>
  <concept>
    <code value="UD"/>
    <display value="Medicaid level of care 13, as defined by each state"/>
  </concept>
  <concept>
    <code value="UE"/>
    <display value="Used durable medical equipment"/>
  </concept>
  <concept>
    <code value="UF"/>
    <display value="Services provided in the morning"/>
  </concept>
  <concept>
    <code value="UG"/>
    <display value="Services provided in the afternoon"/>
  </concept>
  <concept>
    <code value="UH"/>
    <display value="Services provided in the evening"/>
  </concept>
  <concept>
    <code value="UJ"/>
    <display value="Services provided at night"/>
  </concept>
  <concept>
    <code value="UK"/>
    <display
             value="Services provided on behalf of the client to someone other than the client (collateral relationship)"/>
  </concept>
  <concept>
    <code value="UN"/>
    <display value="Two patients served"/>
  </concept>
  <concept>
    <code value="UP"/>
    <display value="Three patients served"/>
  </concept>
  <concept>
    <code value="UQ"/>
    <display value="Four patients served"/>
  </concept>
  <concept>
    <code value="UR"/>
    <display value="Five patients served"/>
  </concept>
  <concept>
    <code value="US"/>
    <display value="Six or more patients served"/>
  </concept>
  <concept>
    <code value="V1"/>
    <display value="Demonstration modifier 1"/>
  </concept>
  <concept>
    <code value="V2"/>
    <display value="Demonstration modifier 2"/>
  </concept>
  <concept>
    <code value="V3"/>
    <display value="Demonstration modifier 3"/>
  </concept>
  <concept>
    <code value="V5"/>
    <display
             value="Vascular catheter (alone or with any other vascular access)"/>
  </concept>
  <concept>
    <code value="V6"/>
    <display
             value="Arteriovenous graft (or other vascular access not including a vascular catheter)"/>
  </concept>
  <concept>
    <code value="V7"/>
    <display value="Arteriovenous fistula only (in use with two needles)"/>
  </concept>
  <concept>
    <code value="V8"/>
    <display value="Infection present"/>
  </concept>
  <concept>
    <code value="V9"/>
    <display value="No infection present"/>
  </concept>
  <concept>
    <code value="VM"/>
    <display
             value="Medicare diabetes prevention program (mdpp) virtual make-up session"/>
  </concept>
  <concept>
    <code value="VP"/>
    <display value="Aphakic patient"/>
  </concept>
  <concept>
    <code value="X1"/>
    <display
             value="Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care"/>
  </concept>
  <concept>
    <code value="X2"/>
    <display
             value="Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services"/>
  </concept>
  <concept>
    <code value="X3"/>
    <display
             value="Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital"/>
  </concept>
  <concept>
    <code value="X4"/>
    <display
             value="Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period"/>
  </concept>
  <concept>
    <code value="X5"/>
    <display
             value="Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician"/>
  </concept>
  <concept>
    <code value="XE"/>
    <display
             value="Separate encounter, a service that is distinct because it occurred during a separate encounter"/>
  </concept>
  <concept>
    <code value="XP"/>
    <display
             value="Separate practitioner, a service that is distinct because it was performed by a different practitioner"/>
  </concept>
  <concept>
    <code value="XS"/>
    <display
             value="Separate structure, a service that is distinct because it was performed on a separate organ/structure"/>
  </concept>
  <concept>
    <code value="XU"/>
    <display
             value="Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service"/>
  </concept>
  <concept>
    <code value="ZA"/>
    <display value="Novartis/sandoz"/>
  </concept>
  <concept>
    <code value="ZB"/>
    <display value="Pfizer/hospira"/>
  </concept>
  <concept>
    <code value="ZC"/>
    <display value="Merck/samsung bioepis"/>
  </concept>
  <concept>
    <code value="22"/>
    <display value="Increased procedural svc"/>
    <definition value="Increased procedural services"/>
  </concept>
  <concept>
    <code value="23"/>
    <display value="Unusual anesthesia"/>
    <definition value="Unusual anesthesia"/>
  </concept>
  <concept>
    <code value="24"/>
    <display value="Oth E/M-same phys postop"/>
    <definition
                value="Unrelated Evaluation and Management Service by the Same physician During a Postoperative Period"/>
  </concept>
  <concept>
    <code value="25"/>
    <display value="SignificantE/M same phys/px"/>
    <definition
                value="Significant E/M-same physician day of procedure/service"/>
  </concept>
  <concept>
    <code value="26"/>
    <display value="Professional component"/>
    <definition value="Professional component"/>
  </concept>
  <concept>
    <code value="27"/>
    <display value="Mult outpt E/M same date"/>
    <definition
                value="Multiple Outpatient Hospital E/M Encounters on the Same Date"/>
  </concept>
  <concept>
    <code value="32"/>
    <display value="Mandated services"/>
    <definition value="Mandated services"/>
  </concept>
  <concept>
    <code value="33"/>
    <display value="Preventive services"/>
    <definition value="Preventive services"/>
  </concept>
  <concept>
    <code value="47"/>
    <display value="Anesthesia by surgeon"/>
    <definition value="Anesthesia by surgeon"/>
  </concept>
  <concept>
    <code value="50"/>
    <display value="Bilateral procedure"/>
    <definition value="Bilateral procedure"/>
  </concept>
  <concept>
    <code value="51"/>
    <display value="Multiple procedures"/>
    <definition value="Multiple procedures"/>
  </concept>
  <concept>
    <code value="52"/>
    <display value="Reduced services"/>
    <definition value="Reduced services"/>
  </concept>
  <concept>
    <code value="53"/>
    <display value="Discontinued procedure"/>
    <definition value="Discontinued procedure"/>
  </concept>
  <concept>
    <code value="54"/>
    <display value="Surgical care only"/>
    <definition value="Surgical care only"/>
  </concept>
  <concept>
    <code value="55"/>
    <display value="Postoperative management only"/>
    <definition value="Postoperative management only"/>
  </concept>
  <concept>
    <code value="56"/>
    <display value="Preoperative management only"/>
    <definition value="Preoperative management only"/>
  </concept>
  <concept>
    <code value="57"/>
    <display value="Decision for surgery"/>
    <definition value="Decision for surgery"/>
  </concept>
  <concept>
    <code value="58"/>
    <display value="Stg/rel px by same phys"/>
    <definition
                value="Staged or Related Procedure or Service by the Same Physician During the Postoperative Period"/>
  </concept>
  <concept>
    <code value="59"/>
    <display value="Distinct procedural svc"/>
    <definition value="Distinct procedural service"/>
  </concept>
  <concept>
    <code value="62"/>
    <display value="Two surgeons"/>
    <definition value="Two surgeons"/>
  </concept>
  <concept>
    <code value="63"/>
    <display value="Px on infants &lt;4 kg"/>
    <definition value="Procedure performed on insants less than 4 kg"/>
  </concept>
  <concept>
    <code value="66"/>
    <display value="Surgical team"/>
    <definition value="Surgical team"/>
  </concept>
  <concept>
    <code value="73"/>
    <display value="D/C OP/ASC px prior anes"/>
    <definition
                value="Discontinued outpatient/ASC procedure prior to administration of anesthesia"/>
  </concept>
  <concept>
    <code value="74"/>
    <display value="D/C OP/ASC px after anes"/>
    <definition
                value="Discontinued outpatient/ASC procedure after administration of anesthesia"/>
  </concept>
  <concept>
    <code value="76"/>
    <display value="Repeat px-same phys/HCP"/>
    <definition
                value="Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional"/>
  </concept>
  <concept>
    <code value="77"/>
    <display value="Repeat px-another phys/HCP"/>
    <definition value="Repeat procedure, different provider"/>
  </concept>
  <concept>
    <code value="78"/>
    <display value="Unplan return OR-rel px"/>
    <definition
                value="Unplanned return to operating room during postoperative care, related procedure by the same provider"/>
  </concept>
  <concept>
    <code value="79"/>
    <display value="Px postop-same phys"/>
    <definition
                value="Unrelated Procedure or Service by the Same Physician During the Postoperative Period"/>
  </concept>
  <concept>
    <code value="80"/>
    <display value="Assistant surgeon"/>
    <definition value="Assistant surgeon"/>
  </concept>
  <concept>
    <code value="81"/>
    <display value="Minimum asst surgeon"/>
    <definition value="Minimum assistant surgeon"/>
  </concept>
  <concept>
    <code value="82"/>
    <display value="Asst surgeon-no resident"/>
    <definition
                value="Assistant Surgeon (when qualified resident surgeon not available)"/>
  </concept>
  <concept>
    <code value="90"/>
    <display value="Reference (outside) lab"/>
    <definition value="Reference (outside) laboratory"/>
  </concept>
  <concept>
    <code value="91"/>
    <display value="Repeat dxtic lab test"/>
    <definition value="Repeat clinical diagnostic laboratory test"/>
  </concept>
  <concept>
    <code value="92"/>
    <display value="Alt lab platform testing"/>
    <definition value="Alternative laboratory platform testing"/>
  </concept>
  <concept>
    <code value="95"/>
    <display value="Synch telemedicine svc"/>
    <definition
                value="Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system"/>
  </concept>
  <concept>
    <code value="96"/>
    <display value="Habilitative Services"/>
    <definition value="Habilitative Services"/>
  </concept>
  <concept>
    <code value="97"/>
    <display value="Rehabilitative Services"/>
    <definition value="Rehabilitative Services"/>
  </concept>
  <concept>
    <code value="99"/>
    <display value="Multiple modifiers"/>
    <definition value="Multiple modifiers"/>
  </concept>
</CodeSystem>