Modifiers help identify special circumstances that apply when a service was provided. Current Procedural Terminology (CPT) modifiers are 2 digits (eg, 50, bilateral procedure). Modifiers often affect whether a health plan pays or does not pay for a service. Some modifiers commonly used in pediatric coding are included in the Table.

Not all modifiers affect payment. Some modifiers are generally considered informational. Payers often publish information on which modifiers affect payment and which are informational only (eg, 47, anesthesia by surgeon).

Modifiers are also part of the Healthcare Common Procedure Coding System (HCPCS) Level II code set. CPT and HCPCS modifiers are not limited to use with codes in the same HCPCS level. For instance, HCPCS modifier TC (technical component) is used to indicate that only the technical component of a service was provided by the reporting individual/facility; another individual may report the same code...

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