|
Type
Key:
GP
=
Global Package Modifier
CCI
= related to bundling / CCI
E/M
only =
Appended to E/M codes only
#
= Related to number of surgeons
Oth
= All Others
|
$$
Key:
Û = $$ goes up;
Þ = $$ claim gets paid - without it claim would be denied;
Ü = $$ goes down;
Ú = $$ Stays the same (informational only)
|
|
|
Type
|
$$
|
E/M
|
Anesthesia
|
Surgery
|
Radiology
|
Path
& Lab
|
Medicine
|
ASC
& Hosp
|
Global
Package Modifiers
|
|
-24
|
Unrelated
E/M service by the same physician during a postop
period
|
GP
&
E/M
Only
|
Þ
|
E/M
|
|
|
|
|
|
|
|
-25
|
Significant
separately identifiable E/M service
|
GP&
E/M
Only
|
Þ
|
E/M
|
|
|
|
|
|
ASC
& Hosp
|
|
-57
|
Decision
for surgery
|
GP
&
E/M
Only
|
Þ
|
E/M
|
|
|
|
|
Medicine
|
|
|
-54
|
Surgical
care only
|
GP
|
Ü
|
|
|
Surgery
|
|
|
|
|
|
-55
|
Postoperative
management only
|
GP
|
Ü
|
|
|
Surgery
|
|
|
Medicine
|
|
|
-56
|
Preoperative
management only
|
GP
|
Ü
|
|
|
Surgery
|
|
|
Medicine
|
|
|
-58
|
Staged
or related procedure
|
GP
|
Þ
|
|
|
Surgery
|
Radiology
|
|
Medicine
|
ASC
& Hosp
|
|
-76
|
Repeat
procedure by same physician
|
GP
&
Oth
|
Ü,
Þ
|
|
|
Surgery
|
Radiology
|
|
Medicine
|
ASC
& Hosp
|
|
-77
|
Repeat
procedure by another physician
|
GP
|
Þ
|
|
|
Surgery
|
Radiology
|
|
Medicine
|
ASC
& Hosp
|
|
-78
|
Return
to OR for a related procedure during the postop
period
|
GP
|
ÜÞ
|
|
|
Surgery
|
Radiology
|
|
Medicine
|
ASC
& Hosp
|
|
-79
|
Unrelated
procedure or service by the same physician during
the postop period
|
GP
|
Þ
|
|
|
Surgery
|
Radiology
|
|
Medicine
|
ASC
& Hosp
|
Bundling
or CCI Modifiers
|
|
-25
|
Significant
separately identifiable E/M service
|
GP&
E/M
Only
|
Þ
|
E/M
|
|
|
|
|
|
ASC
& Hosp
|
|
-26
|
Professional
component
|
CCI
|
Ü
|
|
|
Surgery
|
Radiology
|
Path
& Lab
|
Medicine
|
|
|
-59
|
Distinct
procedural service
|
CCI
|
Þ
|
|
Anesthesia
|
Surgery
|
Radiology
|
Path
& Lab
|
Medicine
|
ASC
& Hosp
|
|
-25
|
Significant
separately identifiable E/M service
|
GP&
E/M
Only &
CCI
|
Þ
|
E/M
|
|
|
|
|
|
ASC
& Hosp
|
Evaluation
& Management Only Modifiers
|
|
-21
|
Prolonged
E/M services
|
E/M
Only
|
Ú
|
|
|
|
|
|
|
|
|
-24
|
Unrelated
E/M service by the same physician during a postop
period
|
GP
&
E/M
Only
|
Þ
|
E/M
|
|
|
|
|
|
|
|
-25
|
Significant
separately identifiable E/M service
|
GP&
E/M
Only
|
Þ
|
E/M
|
|
|
|
|
|
ASC
& Hosp
|
|
-57
|
Decision
for surgery
|
GP
&
E/M
Only
|
Þ
|
E/M
|
|
|
|