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HCPCS Modifiers

HCPCS Modifiers - Modifiers for HCPCS codes

 

Modifiers for HCPCS codes
CD
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
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 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
 
CH
0 percent impaired, limited or restricted
 
CI
At least 1 percent but less than 20 percent impaired, limited or restricted
 
CJ
At least 20 percent but less than 40 percent impaired, limited or restricted
 
CK
At least 40 percent but less than 60 percent impaired, limited or restricted
 
CL
At least 60 percent but less than 80 percent impaired, limited or restricted
 
CM
At least 80 percent but less than 100 percent impaired, limited or restricted
 
CN
100 percent impaired, limited or restricted
 
CO
Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
 
CQ
Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
 
CR
Catastrophe/disaster related
 
CS
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
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 assessment by a licensed health professional other than a dentist
 
E1
Upper left, eyelid
 
E2
Lower left, eyelid
 
E3
Upper right, eyelid
 
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