Guided Notes

Modifiers in Depth

Every modifier family a coder uses — E/M, procedure, anatomic, global surgery, repeat, reduced/discontinued, assistant surgeon, payment and HCPCS informational modifiers — and how to sequence them.

Two kinds of modifiers

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• Pricing (payment) modifiers change how much is paid: 26, TC, 50, 51, 52, 53, 62, 80, 82, AS, QK/QX/QZ. • Informational (statistical) modifiers give extra information or bypass edits but don't change the fee: RT/LT, 59/X{EPSU}, 25, 76/77, GA/GY/GZ, FA–F9, TA–T9.

Sequencing: put pricing modifiers in the first position(s), then informational ones. Most claims allow up to 4 modifiers per line.

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