• Multiple Modifiers are required on one line of service.
• Reportable on all procedure codes
• Report modifier 99 in the first modifier position on the line of service
o list all other modifiers in item 19 or the equivalent electronic data field.
• If the claim has more than one detail line, indicate the detail line number in Item 19 or the equivalent electronic data field.
• Reporting three different modifiers in the first three modifier fields and then 99 in the fourth.
• Reporting less than five modifiers for one line of service
When more than four modifiers are needed to describe a service on the same code, replace with modifier 99.
Reflect all modifiers involved in Item 19 narrative or electronic equivalent
Replace with modifier 99 in Item 24D
Documentation must explain all modifiers involved
Includes informational and pricing modifiers
Certain modifiers may affect payment
In this situation, do not append other modifiers in Item 24D
Claim Coding Example
Patient had a Mohs removal (within 90 day global) on the left cheek and then another on the right cheek (RT) by the same provider, repeated twice (i.e., 79, 59, RT) and not enough modifier spaces.
Mohs micrographic technique, including removal