Modifier Codes

A modifier provides the means by which the reporting physician or provider can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code. The judicious application of modifiers obviates the necessity for separate procedure listings that may describe the modifying circumstance. Modifiers may be used to indicate to the recipient of a report that:

A service or procedure has both a professional and technical component.

A service or procedure was performed by more than one physician and/or in more than one location.

A service or procedure has been increased or reduced.

Only part of a service was performed.

An adjunctive service was performed.

A bilateral procedure was performed.

A service or procedure was provided more than once.

Unusual events occurred.

HCPCS modifier codes are divided into two levels, or groups, as described below:

Level I

Codes and descriptors copyrighted by the American Medical Association's current procedural terminology, fourth edition (CPT-4). These are 2 position numeric codes.

**** NOTE: ****

CPT-4 codes including long, short and consumer friendly descriptions shall be used in accordance with the CMS/AMA agreement. Any other use violates the AMA copyright.

Level II

Codes and descriptors approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). These are 2 position alpha-numeric codes.

Code	Short Description	Long Description
A1	Dressing for one wound	Dressing for one wound
A2	Dressing for two wounds	Dressing for two wounds
A3	Dressing for three wounds	Dressing for three wounds
A4	Dressing for four wounds	Dressing for four wounds
A5	Dressing for five wounds	Dressing for five wounds
A6	Dressing for six wounds	Dressing for six wounds
A7	Dressing for seven wounds	Dressing for seven wounds
A8	Dressing for eight wounds	Dressing for eight wounds
A9	Dressing for 9 or more wound	Dressing for nine or more wounds
AA	Anesthesia perf by anesgst	Anesthesia services performed personally by anesthesiologist
AD	Md supervision, >4 anes proc	Medical supervision by a physician: more than four concurrent anesthesia procedures
AE	Registered dietician	Registered dietician
AF	Specialty physician	Specialty physician
AG	Primary physician	Primary physician
AH	Clinical psychologist	Clinical psychologist
AI	Principal physician of rec	Principal physician of record
AJ	Clinical social worker	Clinical social worker
AK	Non participating physician	Non participating physician
AM	Physician, team member svc	Physician, team member service
AO	Prov declined alt pmt method	Alternate payment method declined by provider of service
AP	No dtmn of refractive state	Determination of refractive state was not performed in the course of diagnostic ophthalmological examination
AQ	Physician service hpsa area	Physician providing a service in an unlisted health professional shortage area (hpsa)
AR	Physician scarcity area	Physician provider services in a physician scarcity area
AS	Assistant at surgery service	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
AT	Acute treatment	Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)
AU	Uro, ostomy or trach item	Item furnished in conjunction with a urological, ostomy, or tracheostomy supply
AV	Item w prosthetic/orthotic	Item furnished in conjunction with a prosthetic device, prosthetic or orthotic
AW	Item w a surgical dressing	Item furnished in conjunction with a surgical dressing
AX	Item w dialysis services	Item furnished in conjunction with dialysis services
AY	Item/service not for esrd tx	Item or service furnished to an esrd patient that is not for the treatment of esrd
AZ	Physician serv in dent hpsa	Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment
BA	Item w pen services	Item furnished in conjunction with parenteral enteral nutrition (pen) services
BL	Spec acquisition blood prods	Special acquisition of blood and blood products
BO	Nutrition oral admin no tube	Orally administered nutrition, not by feeding tube
BP	Bene electd to purchase item	The beneficiary has been informed of the purchase and rental options and has elected to purchase the item
BR	Bene elected to rent item	The beneficiary has been informed of the purchase and rental options and has elected to rent the item
BU	Bene undecided on purch/rent	The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision
CA	Procedure payable inpatient	Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission
CB	Esrd bene part a snf-sep pay	Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable
CC	Procedure code change	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CD	Amcc test for esrd or mcp md	Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable
CE	Med neces amcc tst sep reimb	Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity
CF	Amcc tst not composite rate	Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable
CG	Policy criteria applied	Policy criteria applied
CH	0 percent impaired, ltd, res	0 percent impaired, limited or restricted
CI	1 to <20 percent impaired	At least 1 percent but less than 20 percent impaired, limited or restricted
CJ	20 to <40 percent impaired	At least 20 percent but less than 40 percent impaired, limited or restricted
CK	40 to <60 percent impaired	At least 40 percent but less than 60 percent impaired, limited or restricted
CL	60 to <80 percent impaired	At least 60 percent but less than 80 percent impaired, limited or restricted
CM	80 to <100 percent impaired	At least 80 percent but less than 100 percent impaired, limited or restricted
CN	100 percent impaired, ltd	100 percent impaired, limited or restricted
CO	Outpatient ot service by ota	Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
CP	C-apc adjunctive service	Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure, but reported on a different claim
CQ	Outpatient pt service by pta	Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
CR	Catastrophe/disaster related	Catastrophe/disaster related
CS	Gulf oil 2010 spill related	Item or service related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the gulf of mexico, including but not limited to subsequent clean-up activities
CT	Ct does not meet nema standa	Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard
DA	Oral health assess, not dent	Oral health assessment by a licensed health professional other than a dentist
E1	Upper left eyelid	Upper left, eyelid
E2	Lower left eyelid	Lower left, eyelid
E3	Upper right eyelid	Upper right, eyelid
E4	Lower right eyelid	Lower right, eyelid
EA	Esa, anemia, chemo-induced	Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy
EB	Esa, anemia, radio-induced	Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy
EC	Esa, anemia, non-chemo/radio	Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy
ED	Hct>39% or hgb>13g>=3 cycle	Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
EE	Hct>39% or hgb>13g<3 cycle	Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
EJ	Subsequent claim	Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab
EM	Emer reserve supply (esrd)	Emergency reserve supply (for esrd benefit only)
EP	Medicaid epsdt program svc	Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program
ER	Off-campus ed service	Items and services furnished by a provider-based, off-campus emergency department
ET	Emergency services	Emergency services
EX	Expatriate beneficiary	Expatriate beneficiary
EY	No md order for item/service	No physician or other licensed health care provider order for this item or service
F1	Left hand, second digit	Left hand, second digit
F2	Left hand, third digit	Left hand, third digit
F3	Left hand, fourth digit	Left hand, fourth digit
F4	Left hand, fifth digit	Left hand, fifth digit
F5	Right hand, thumb	Right hand, thumb
F6	Right hand, second digit	Right hand, second digit
F7	Right hand, third digit	Right hand, third digit
F8	Right hand, fourth digit	Right hand, fourth digit
F9	Right hand, fifth digit	Right hand, fifth digit
FA	Left hand, thumb	Left hand, thumb
FB	Item provided without cost	Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)
FC	Part credit, replaced device	Partial credit received for replaced device
FP	Svc part of family plan pgm	Service provided as part of family planning program
FX	X-ray taken using film	X-ray taken using film
FY	Computed radiography x-ray	X-ray taken using computed radiography technology/cassette-based imaging
G0	Telestroke	Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke
G1	Urr reading of less than 60	Most recent urr reading of less than 60
G2	Urr reading of 60 to 64.9	Most recent urr reading of 60 to 64.9
G3	Urr reading of 65 to 69.9	Most recent urr reading of 65 to 69.9
G4	Urr reading of 70 to 74.9	Most recent urr reading of 70 to 74.9
G5	Urr reading of 75 or greater	Most recent urr reading of 75 or greater
G6	Esrd patient <6 dialysis/mth	Esrd patient for whom less than six dialysis sessions have been provided in a month
G7	Payment limits do not apply	Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening
G8	Monitored anesthesia care	Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure
G9	Mac for at risk patient	Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
GA	Liability waiver ind case	Waiver of liability statement issued as required by payer policy, individual case
GB	Claim resubmitted	Claim being re-submitted for payment because it is no longer covered under a global payment demonstration
GC	Resident/teaching phys serv	This service has been performed in part by a resident under the direction of a teaching physician
GD	Unit of service > mue value	Units of service exceeds medically unlikely edit value and represents reasonable and necessary services
GE	Resident prim care exception	This service has been performed by a resident without the presence of a teaching physician under the primary care exception
GF	Nonphysician serv c a hosp	Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
GG	Payment screen mam + diagmam	Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day
GH	Diag mammo to screening mamo	Diagnostic mammogram converted from screening mammogram on same day
GJ	Opt out provider of er srvc	"opt out"" physician or practitioner emergency or urgent service"
GK	Actual item/service ordered	Reasonable and necessary item/service associated with a ga or gz modifier
GL	Upgraded item, no charge	Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
GM	Multiple transports	Multiple patients on one ambulance trip
GN	Op speech language service	Services delivered under an outpatient speech language pathology plan of care
GO	Op occupational therapy serv	Services delivered under an outpatient occupational therapy plan of care
GP	Op pt services	Services delivered under an outpatient physical therapy plan of care
GQ	Telehealth store and forward	Via asynchronous telecommunications system
GR	Service by va resident	This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy
GS	Epo/darbepoietin reduced 25%	Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level
GT	Interactivetelecommunication	Via interactive audio and video telecommunication systems
GU	Liability waiver rout notice	Waiver of liability statement issued as required by payer policy, routine notice
GV	Attending phys not hospice	Attending physician not employed or paid under arrangement by the patient's hospice provider
GW	Service unrelated to term co	Service not related to the hospice patient's terminal condition
GX	Voluntary liability notice	Notice of liability issued, voluntary under payer policy
GY	Statutorily excluded	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ	Not reasonable and necessary	Item or service expected to be denied as not reasonable and necessary
H9	Court-ordered	Court-ordered
HA	Child/adolescent program	Child/adolescent program
HB	Adult program non-geriatric	Adult program, non geriatric
HC	Adult program geriatric	Adult program, geriatric
HD	Pregnant/parenting program	Pregnant/parenting women's program
HE	Mental health program	Mental health program
HF	Substance abuse program	Substance abuse program
HG	Opioid addiction tx program	Opioid addiction treatment program
HH	Mental hlth/substance abs pr	Integrated mental health/substance abuse program
HI	Men hlth intel/dev disab pgm	Integrated mental health and intellectual disability/developmental disabilities program
HJ	Employee assistance program	Employee assistance program
HK	Spec hgh rsk mntl hlth pop p	Specialized mental health programs for high-risk populations
HL	Intern	Intern
HM	Less than bachelor degree lv	Less than bachelor degree level
HN	Bachelors degree level	Bachelors degree level
HO	Masters degree level	Masters degree level
HP	Doctoral level	Doctoral level
HQ	Group setting	Group setting
HR	Family/couple w client prsnt	Family/couple with client present
HS	Family/couple w/o client prs	Family/couple without client present
HT	Multi-disciplinary team	Multi-disciplinary team
HU	Child welfare agency funded	Funded by child welfare agency
HV	Funded state addiction agncy	Funded state addictions agency
HW	State mntl hlth agncy funded	Funded by state mental health agency
HX	County/local agency funded	Funded by county/local agency
HY	Funded by juvenile justice	Funded by juvenile justice agency
HZ	Criminal justice agncy fund	Funded by criminal justice agency
J1	Cap no-pay for prescript num	Competitive acquisition program no-pay submission for a prescription number
J2	Cap restock of emerg drugs	Competitive acquisition program, restocking of emergency drugs after emergency administration
J3	Cap drug unavail thru cap	Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology
J4	Dmepos comp bid furn by hosp	Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge
JA	Administered intravenously	Administered intravenously
JB	Administered subcutaneously	Administered subcutaneously
JC	Skin substitute graft	Skin substitute used as a graft
JD	Skin sub not used as a graft	Skin substitute not used as a graft
JE	Administered via dialysate	Administered via dialysate
JF	Compounded drug	Compounded drug
JG	340b acquired drug	Drug or biological acquired with 340b drug pricing program discount
JW	Discarded drug not administe	Drug amount discarded/not administered to any patient
K0	Lwr ext prost functnl lvl 0	Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.
K1	Lwr ext prost functnl lvl 1	Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.
K2	Lwr ext prost functnl lvl 2	Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator.
K3	Lwr ext prost functnl lvl 3	Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.
K4	Lwr ext prost functnl lvl 4	Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.
KA	Wheelchair add-on option/acc	Add on option/accessory for wheelchair
KB	>4 modifiers on claim	Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim
KC	Repl special pwr wc intrface	Replacement of special power wheelchair interface
KD	Drug/biological dme infused	Drug or biological infused through dme
KE	Bid under round 1 dmepos cb	Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment
KF	Fda class iii device	Item designated by fda as class iii device
KG	Dmepos comp bid prgm no 1	Dmepos item subject to dmepos competitive bidding program number 1
KH	Dmepos ini clm, pur/1 mo rnt	Dmepos item, initial claim, purchase or first month rental
KI	Dmepos 2nd or 3rd mo rental	Dmepos item, second or third month rental
KJ	Dmepos pen pmp or 4-15mo rnt	Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
KK	Dmepos comp bid prgm no 2	Dmepos item subject to dmepos competitive bidding program number 2
KL	Dmepos mailorder comp bid	Dmepos item delivered via mail
KM	Rplc facial prosth new imp	Replacement of facial prosthesis including new impression/moulage
KN	Rplc facial prosth old mod	Replacement of facial prosthesis using previous master model
KO	Single drug unit dose form	Single drug unit dose formulation
KP	First drug of multi drug u d	First drug of a multiple drug unit dose formulation
KQ	2nd/subsqnt drg multi drg ud	Second or subsequent drug of a multiple drug unit dose formulation
KR	Rental item partial month	Rental item, billing for partial month
KS	Glucose monitor supply	Glucose monitor supply for diabetic beneficiary not treated with insulin
KT	Item from noncontract supply	Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
KU	Dmepos comp bid prgm no 3	Dmepos item subject to dmepos competitive bidding program number 3
KV	Dmepos item, profession serv	Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
KW	Dmepos comp bid prgm no 4	Dmepos item subject to dmepos competitive bidding program number 4
KX	Documentation on file	Requirements specified in the medical policy have been met
KY	Dmepos comp bid prgm no 5	Dmepos item subject to dmepos competitive bidding program number 5
KZ	New cov not implement by m+c	New coverage not implemented by managed care
L1	Separately payable lab test	Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps
LC	Lft circum coronary artery	Left circumflex coronary artery
LD	Left ant des coronary artery	Left anterior descending coronary artery
LL	Lease/rental (appld to pur)	Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)
LM	Left main coronary artery	Left main coronary artery
LR	Laboratory round trip	Laboratory round trip
LS	Fda-monitored iol implant	Fda-monitored intraocular lens implant
LT	Left side	Left side (used to identify procedures performed on the left side of the body)
M2	Medicare secondary payer	Medicare secondary payer (msp)
MA	Emer med cond susp/confirm	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	Auc hardship, insuf internet	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
MC	Auc hardship, vendor issues	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	Auc hardship, extreme circ	Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances
ME	Order adheres to auc	The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MF	Order does not adhere to auc	The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MG	Auc not applicable to order	The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
MH	Auc consult not provided	Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
MS	6-mo maint/svc fee parts/lbr	Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty
NB	Drug specific nebulizer	Nebulizer system, any type, fda-cleared for use with specific drug
NR	New when rented	New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)
NU	New equipment	New equipment
P1	Normal healthy patient	A normal healthy patient
P2	Patient w/mild syst disease	A patient with mild systemic disease
P3	Patient w/severe sys disease	A patient with severe systemic disease
P4	Pt w/sev sys dis threat life	A patient with severe systemic disease that is a constant threat to life
P5	Pt not expect surv w/o oper	A moribund patient who is not expected to survive without the operation
P6	Brain-dead pt organs removed	A declared brain-dead patient whose organs are being removed for donor purposes
PA	Surgery, wrong body part	Surgical or other invasive procedure on wrong body part
PB	Surgery, wrong patient	Surgical or other invasive procedure on wrong patient
PC	Wrong surgery on patient	Wrong surgery or other invasive procedure on patient
PD	Inp admit w/in 3 days	Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PI	Pet tumor init tx strat	Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing
PL	Progressive addition lenses	Progressive addition lenses
PM	Post mortem	Post mortem
PN	Non-excepted off-campus svc	Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
PO	Excepted off-campus service	Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
PS	Pet tumor subsq tx strategy	Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy
PT	Clrctal screen to diagn	Colorectal cancer screening test; converted to diagnostic test or other procedure
Q0	Invest clinical research	Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1	Routine clinical research	Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q2	Demo procedure, service	Demonstration procedure/service
Q3	Live donor surgery/services	Live kidney donor surgery and related services
Q4	Svc exempt - ordrg/rfrng md	Service for ordering/referring physician qualifies as a service exemption
Q5	Recip bill arr subs md or pt	Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q6	Fee/time comp subst md or pt	Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q7	One class a finding	One class a finding
Q8	Two class b findings	Two class b findings
Q9	1 class b & 2 class c fndngs	One class b and two class c findings
QA	Avg sta day/night o2 < 1 lpm	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)
QB	Avg day/nite o2 > 4 lpm/port	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed
QC	Single channel monitoring	Single channel monitoring
QD	Rcrdg/strg in sld st memory	Recording and storage in solid state memory by a digital recorder
QE	Stationary o2 @ rest <1 lpm	Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)
QF	Station o2 @ rest >4lpm/port	Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed
QG	Station o2 @ rest > 4 lpm	Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)
QH	Oxygen cnsrvg dvc w del sys	Oxygen conserving device is being used with an oxygen delivery system
QJ	Patient in state/locl custod	Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
QK	Med dir 2-4 cncrnt anes proc	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
QL	Patient died after amb call	Patient pronounced dead after ambulance called
QM	Ambulance arr by provider	Ambulance service provided under arrangement by a provider of services
QN	Ambulance furn by provider	Ambulance service furnished directly by a provider of services
QP	Individually ordered lab tst	Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060.
QQ	Qualified cdsm consulted	Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
QR	Avg sta day/night o2 > 4 lpm	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)
QS	Monitored anesthesia care	Monitored anesthesia care service
QT	Rcrdg/strg tape analog recdr	Recording and storage on tape by an analog tape recorder
QW	Clia waived test	Clia waived test
QX	Crna svc w/ md med direction	Crna service: with medical direction by a physician
QY	Medically directed crna	Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist
QZ	Crna svc w/o med dir by md	Crna service: without medical direction by a physician
RA	Replacement of dme item	Replacement of a dme, orthotic or prosthetic item
RB	Replacement part, dme item	Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair
RC	Right coronary artery	Right coronary artery
RD	Drug admin not incident-to	Drug provided to beneficiary, but not administered "incident-to"""
RE	Furnish full compliance rems	Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)
RI	Ramus intermedius cor artery	Ramus intermedius coronary artery
RR	Rental (dme)	Rental (use the 'rr' modifier when dme is to be rented)
RT	Right side	Right side (used to identify procedures performed on the right side of the body)
SA	Nurse practitioner w physici	Nurse practitioner rendering service in collaboration with a physician
SB	Nurse midwife	Nurse midwife
SC	Medically necessary serv/sup	Medically necessary service or supply
SD	Serv by home infusion rn	Services provided by registered nurse with specialized, highly technical home infusion training
SE	State/fed funded program/ser	State and/or federally-funded programs/services
SF	2nd opinion ordered by pro	Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)
SG	Asc facility service	Ambulatory surgical center (asc) facility service
SH	2nd concurrent infusion ther	Second concurrently administered infusion therapy
SJ	3rd concurrent infusion ther	Third or more concurrently administered infusion therapy
SK	High risk population	Member of high risk population (use only with codes for immunization)
SL	State supplied vaccine	State supplied vaccine
SM	Second opinion	Second surgical opinion
SN	Third opinion	Third surgical opinion
SQ	Item ordered by home health	Item ordered by home health
SS	Hit in infusion suite	Home infusion services provided in the infusion suite of the iv therapy provider
ST	Related to trauma or injury	Related to trauma or injury
SU	Performed in phys office	Procedure performed in physician's office (to denote use of facility and equipment)
SV	Drugs delivered not used	Pharmaceuticals delivered to patient's home but not utilized
SW	Serv by cert diab educator	Services provided by a certified diabetic educator
SY	Contact w/high-risk pop	Persons who are in close contact with member of high-risk population (use only with codes for immunization)
SZ	Habilitative services	Habilitative services
T1	Left foot, second digit	Left foot, second digit
T2	Left foot, third digit	Left foot, third digit
T3	Left foot, fourth digit	Left foot, fourth digit
T4	Left foot, fifth digit	Left foot, fifth digit
T5	Right foot, great toe	Right foot, great toe
T6	Right foot, second digit	Right foot, second digit
T7	Right foot, third digit	Right foot, third digit
T8	Right foot, fourth digit	Right foot, fourth digit
T9	Right foot, fifth digit	Right foot, fifth digit
TA	Left foot, great toe	Left foot, great toe
TB	Tracking 340b acquired drug	Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
TC	Technical component	Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
TD	Rn	Rn
TE	Lpn/lvn	Lpn/lvn
TF	Intermediate level of care	Intermediate level of care
TG	Complex/high tech level care	Complex/high tech level of care
TH	Ob tx/srvcs prenatl/postpart	Obstetrical treatment/services, prenatal or postpartum
TJ	Child/adolescent program gp	Program group, child and/or adolescent
TK	Extra patient or passenger	Extra patient or passenger, non-ambulance
TL	Early intervention ifsp	Early intervention/individualized family service plan (ifsp)
TM	Individualized ed prgrm(iep)	Individualized education program (iep)
TN	Rural/out of service area	Rural/outside providers' customary service area
TP	Med transprt unloaded vehicl	Medical transport, unloaded vehicle
TQ	Bls by volunteer amb providr	Basic life support transport by a volunteer ambulance provider
TR	School-based iep out of dist	School-based individualized education program (iep) services provided outside the public school district responsible for the student
TS	Follow-up service	Follow-up service
TT	Additional patient	Individualized service provided to more than one patient in same setting
TU	Overtime payment rate	Special payment rate, overtime
TV	Holiday/weekend payment rate	Special payment rates, holidays/weekends
TW	Back-up equipment	Back-up equipment
U1	M/caid care lev 1 state def	Medicaid level of care 1, as defined by each state
U2	M/caid care lev 2 state def	Medicaid level of care 2, as defined by each state
U3	M/caid care lev 3 state def	Medicaid level of care 3, as defined by each state
U4	M/caid care lev 4 state def	Medicaid level of care 4, as defined by each state
U5	M/caid care lev 5 state def	Medicaid level of care 5, as defined by each state
U6	M/caid care lev 6 state def	Medicaid level of care 6, as defined by each state
U7	M/caid care lev 7 state def	Medicaid level of care 7, as defined by each state
U8	M/caid care lev 8 state def	Medicaid level of care 8, as defined by each state
U9	M/caid care lev 9 state def	Medicaid level of care 9, as defined by each state
UA	M/caid care lev 10 state def	Medicaid level of care 10, as defined by each state
UB	M/caid care lev 11 state def	Medicaid level of care 11, as defined by each state
UC	M/caid care lev 12 state def	Medicaid level of care 12, as defined by each state
UD	M/caid care lev 13 state def	Medicaid level of care 13, as defined by each state
UE	Used durable med equipment	Used durable medical equipment
UF	Services provided, morning	Services provided in the morning
UG	Services provided, afternoon	Services provided in the afternoon
UH	Services provided, evening	Services provided in the evening
UJ	Services provided, night	Services provided at night
UK	Svc on behalf client-collat	Services provided on behalf of the client to someone other than the client (collateral relationship)
UN	Two patients served	Two patients served
UP	Three patients served	Three patients served
UQ	Four patients served	Four patients served
UR	Five patients served	Five patients served
US	Six or more patients served	Six or more patients served
V1	Demonstration modifier 1	Demonstration modifier 1
V2	Demonstration modifier 2	Demonstration modifier 2
V3	Demonstration modifier 3	Demonstration modifier 3
V5	Vascular catheter	Vascular catheter (alone or with any other vascular access)
V6	Arteriovenous graft	Arteriovenous graft (or other vascular access not including a vascular catheter)
V7	Arteriovenous fistula	Arteriovenous fistula only (in use with two needles)
V8	Infection present	Infection present
V9	No infection present	No infection present
VM	Mdpp virtual make-up session	Medicare diabetes prevention program (mdpp) virtual make-up session
VP	Aphakic patient	Aphakic patient
X1	Continuous/broad services	Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
X2	Continuous/focused services	Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
X3	Episodic/broad services	Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital
X4	Episodic/focused services	Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
X5	Svc req by another clinician	Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XE	Separate encounter	Separate encounter, a service that is distinct because it occurred during a separate encounter
XP	Separate practitioner	Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS	Separate organ/structure	Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU	Unusual separate service	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
ZA	Novartis/sandoz	Novartis/sandoz
ZB	Pfizer/hospira	Pfizer/hospira
ZC	Merck/samsung bioepis	Merck/samsung bioepis