Chapter # 2 - What are Commonly Used Modifiers | Top 20 Modifiers in Medical Billing

Commonly Used Modifiers in Medical Billing** Modifiers in medical billing are two-character codes (numeric or alphanumeric) added to CPT or HCPCS codes to provide *additional information about the service* rendered. They help ensure *accurate reimbursement* and avoid claim denials by clarifying circumstances like service changes, multiple procedures, or unusual situations. Commonly Used Modifiers:** 1. *Modifier 25* – Significant, separately identifiable E/M service by the same physician on the same day 2. *Modifier 59* – Distinct procedural service 3. *Modifier 26* – Professional component only 4. *Modifier TC* – Technical component only 5. *Modifier 76* – Repeat procedure by the same provider 6. *Modifier 77* – Repeat procedure by another provider 7. *Modifier 24* – Unrelated E/M service during post-op period 8. *Modifier 51* – Multiple procedures 9. *Modifier 52* – Reduced services 10. *Modifier 53* – Discontinued procedure 11. *Modifier 91* – Repeat clinical diagnostic lab test 12. *Modifier GA* – Waiver of liability (ABN on file) 13. *Modifier GY* – Item/service not covered 14. *Modifier GZ* – Item/service expected to be denied, no ABN 15. *Modifier QW* – CLIA-waived test 16. *Modifier XS* – Separate structure 17. *Modifier XE* – Separate encounter 18. *Modifier XP* – Separate practitioner 19. *Modifier XU* – Unusual non-overlapping service 20. *Modifier KX* – Requirements specified in the medical policy have been met 21. *Modifier 95* – Telehealth service via synchronous communication 22. *Modifier GT* – Via interactive audio and video 23. *Modifier 57* – Decision for surgery 24. *Modifier 58* – Staged or related procedure during post-op period 25. *Modifier 78* – Unplanned return to OR 26. *Modifier 79* – Unrelated procedure during post-op period 27. *Modifier AT* – Active treatment 28. *Modifier CG* – Policy criteria applied 29. *Modifier PO* – Services provided at off-campus outpatient department 30. *Modifier CS* – Cost-sharing waived (COVID-related services) --- *30 Hashtags for Medical Billing Modifiers:* 1. #MedicalModifiers 2. #CPTModifiers 3. #BillingModifiers 4. #Modifier25 5. #Modifier59 6. #Modifier26 7. #ModifierTC 8. #Modifier24 9. #Modifier51 10. #Modifier76 11. #Modifier77 12. #Modifier91 13. #Modifier95 14. #ModifierGT 15. #Modifier57 16. #Modifier58 17. #Modifier78 18. #Modifier79 19. #ModifierGZ 20. #ModifierGA 21. #ModifierGY 22. #ModifierXE 23. #ModifierXS 24. #ModifierXP 25. #ModifierXU 26. #TelehealthModifier 27. #MedicalBilling 28. #CodingAccuracy 29. #ClaimModifiers 30. #HealthcareBilling