Procedure codes are used on claims to convey to a payer what services were provided to a patient. However, more information about how a service was rendered is sometimes necessary for a claim to be properly adjudicated and paid in compliance with coding instructions and health plan policies. Modifiers provide a means of conveying additional information on a claim in lieu of or in conjunction with a narrative statement addressing special circumstances that may affect coverage and payment.

Current Procedural Terminology (CPT®) and the Healthcare Common Procedure Coding System (HCPCS) include modifiers that may be appended to procedure codes to convey additional information. Note that HCPCS modifiers may be appended to CPT codes and vice versa. Physicians and coders should be familiar with modifiers and append a modifier to a procedure code when appropriate based on the circumstances of the service(s) provided.

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