What Are Some Different Medical Coding Modifiers?


Quick Answer

Common medical coding modifiers include those related to procedures, such as modifiers 51 and 53. Modifiers pertaining to evaluation and management services include modifiers 24, 25 and 57. Others, such as modifiers 58 and 59, may apply to both procedures and evaluation and management services, reports University of Florida Health.

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Full Answer

When multiple procedures are performed by the same provider, modifier 51 is affixed to the additional procedure to ensure payment for both the primary and secondary procedure. When a physician elects to terminate a procedure for reasons such as the health of the patient, modifier 53 is attached to the claim. Modifier 24 is used when a physician performs a service during a postoperative period and that service is unrelated to the previous procedure. Similarly, modifier 25 is used when a doctor performs a service that is significant and separate from another service that is performed on the same day. Modifier 57 is appended to a claim when a physician provides a service to a patient and decides that the patient needs a major surgical procedure, University of Florida Health explains.

Modifier 58 is affixed to a procedure or service that was planned and occurs during the postoperative period, was more comprehensive than the previous procedure or is for therapeutic purposes following the original procedure. Modifier 59 is also used to report procedures or services performed on the same day that are commonly not related to one another but are medically necessary. According to University Florida Health, modifier 59 must also be accompanied by extensive documentation supporting the necessity of the different procedures or services.

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