Additional Billing Modifiers Copied

To improve the ability to bill correctly and completely for each type of patient care, we have added 32 additional modifiers in the billing code selection screen.

The new modifiers have been appended to the existing list and appear in the modifiers panels for all codes sets in the E/M Codes screen (see image 1) and for all procedure codes (see image 2) in the Procedure section of the screen.

The modifiers panel in the E/M section contains a scrollbar that allows users to scroll down and view the newly added modifiers within each panel. The procedure modal contains one list on the right side of the screen.

The new modifiers list includes modifiers that apply to Acceptable Use Criteria (AUC), radiology, clinical research, E/M services, and procedure billing. Please confirm with your billing department which modifiers should be used with which billing codes and appointment types.

Please note that the final modifier in the list, NC – No Claim is a custom modifier that can be used for reporting purposes only and should not be sent on a claim.

Additional Billing Modifiers

Modifier	Description
1P	Performance Measure Exclusion Modifier Due to Medical Reasons
2P	Performance Measure Exclusion Modifier Due to Patient Choice
3P	Performance Measure Exclusion Modifier Due to System Reasons
8P	Performance Measure Reporting Modifier – Action Not Performed, Reason Not Otherwise Specified
BP	Beneficiary has elected to purchase
Q0	Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1	Routine clinical service provided in a clinical research study that is in an approved clinical research study
50	Bilateral Procedures
51	Multiple Procedures
52	Reduced Services
53	Discontinued Procedure
79	Unrelated Procedure or Service by the Same Physician During the Postoperative Period
91	Repeat Clinical Diagnostic Laboratory Test
TC	Technical component
26	Global Service or Procedure
33	Preventative Services
PI	Initial Staging
PS	Restaging/Subsequent Treatment Strategy
GV	Attending physician not employed or paid under arrangement by the patient’s hospice provider
GW	Service unrelated to the patient’s terminal condition
KX	Threshold met but medically necessary continued care is essential.
GP	Services provided by a physical therapist. Services delivered under a Physical Therapist Plan of Care
MA	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
MB	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
MC	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
MD	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances
ME	The order for this service adheres to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MF	The order for this service does not adhere to the appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
MG	The order for this service does not have appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MH	Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
QQ	Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
NC	No Claim