CATEGORIES:
1. PRICING modifiers (eg.,21, 22, 26, 50, 52, 53, 60, 62, 80, 82, P1-P6)
2. PAYMENT Eligible Modifier* (eg. 24, 25, 51, 57, 58, 59, 76, 77, 78, 79, 91)
(*presence communicates special situation that might otherwise not be paid
without the modifier based on billing/coding principles and global surgery guidelines)
3. LOCATION Modifiers E1-E4, FA, F1-F9, LC, LD, LT, RC, RT, TA, T1-T9
ORDER OF REPORTING:
- Pricing modifiers before payment modifiers and location modifiers EXCEPT when global surgery package involved, then report payment modifiers before pricing. Example modifier 78 and 62.
- Payment eligible modifiers before location modifiers
- Location modifiers are always last
If you have two pricing modifiers, the most common scenario is likely to involve 26 and another modifier. Always add 26 before any other modifier.
If you have two payment modifiers, a common one is 51 and 59, enter 59 in the first position. If 51 and 78, enter 78 in the first position.
