Saturday, March 6, 2010

Additional HCPCS modifiers

1P Performance Measure Exclusion Modifier Due to Medical Reasons
2P Performance Measure Exclusion Modifier Due to Patient Choice
3P Performance Measure Exclusion Modifier Due to System Reasons
8P Performance Measure Reporting Modifier - Action Not Performed, Reason Not Otherwise Specified
AE Registered Dietician
AF Specialty Physician
AG Primary Physician
AH Clinical Psychologist
AJ Clinical Social Worker
AK Non Participating Physician
AM Physician, team member service
AR Physician providing services in a physician scarcity area
AS Physician assistant, nurse pratitioner, or clinical nurse specialist services for
assistant at surgery
AT Acute Treatment. (Note: Chiropractors must bill the AT modifier when reporting
HCPCS codes 98940, 98941, 98942 to indicate active/corrective treatment. Claims
submitted without the AT modifier will be denied for maintenance therapy. )
AX Item furnished in conjunction with dialysis services.
BL Special Acquisition of blood and blood products.
CB Services ordered by a dialysis physician as part of the ESRD beneficiary’s dialysis benefit, is not part of the composite rate and is separately reimbursable.
CD AMCC test has been ordered by an ESRD facility or MCP physician that is is part of the composite rate and is not separately billable
CE 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.

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