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What Do the Codes of Medical billing modifier list Signify?

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You might have heard it a number of times, “it is not done properly if it is not coded”. There are a number of confusions regarding the real meaning of modifier in the medical arena. Basically, justifying it’s name, a modifier would modify a service, or an item, or a procedure for proper reimbursement. With a modifier, you can make any medical documentation more specific and to-the-point. However, very few tend to have a complete Medical billing modifier list. 

Know the Two Levels 

The two digit modifier codes are mainly divided into different levels. That is to say:

  • Level 1 modifier: Also called CPT modifiers, the American Medical Association or AMA updates in annually.
  • Level 2 modifier: They are also known as HCPCS modifier. The two digit alphanumeric modifiers are maintained and annually updated by the CMS, or Center for Medicare and Medicaid services.

List of the Level 1 Modifiers

Here’s a brief list of Medical billing modifier list that you might find helpful.

  • Modifier 21: prolonged evaluation and management services
  • Modifier 22: Unusual procedural services
  • Modifier 23: Unusual anesthesia
  • Modifier 24: Unrelated evaluation and management service by the same doctor during post-operative time.
  • Modifier 25: Noticeable and identifiably separately evaluation and management service by the physician on the day when procedure is being carried out. 
  • Modifier 26: Professional components
  • Modifier 27: Encounter with multiple patients on the same day
  • Modifier 32: Mandated services
  • Modifier 33: Preventive services
  • Modifier 47: Anesthesia done by the surgeon
  • Modifier 63: Procedures followed on infants who weigh less than 4 kg
  • Modifier 66: Surgical team

List of the Most Important Level 2 Modifiers

Moving on to a list of Level 2 modifiers:

  • A1: Dressing for a wound
  • A2: Dressing for two wounds
  • AJ: Clinical Social Doctor
  • AX: Services pertaining to dialysis
  • AF: Specialty physician
  • AK: Non-participating physician
  • AM: Service as a team member physician
  • AH: Clinical psychologist
  • AV: items that relate to prosthetic procedures
  • AQ: Service rendered in an area where shortage of physicians are seen
  • AE: Registered dietician
  • AG: Primary Physician
  • AW: Items involved in a surgical procedure or surgical dressing
  • AD medical supervision: Over four (4) concurrent anesthesia cases
  • AI: Chief physician of record.

As you have just learned, the codes keep on changing from one year to the other. So it is essential that you keep checking for the updated list.