Forum - Questions & Answers

Mar 8th, 2012 - cbishop 3 

Order of modifiers

Is there a guideline for the order modifiers should go in?
I recently had a surgical assist claim that needed modifiers 80, 50 and 58. What is the correct order of these modifiers on the claim?

Thank you for your help!

Mar 8th, 2012 - nmaguire   2,606 

re: Order of modifiers

Highest down: 80-58-50

Mar 8th, 2012 - youngblood 278 

re: Order of modifiers

Does the latter hold true for alphabetical modifiers?

Mar 10th, 2012 -

re: Order of modifiers

modifiers should be coded in order of importance; also, modifiers should be coded numeric first, alpha-numeric secondary, & alpha tertiary

Mar 12th, 2012 - cbishop 3 

re: Order of modifiers

Thank you for your responses.
Does anyone know of a written guideline for modifier order?

May 3rd, 2012 - ch76606 123 

re: Order of modifiers

I am still looking for "official" guidelines, but I found this from AAPC:

guidelines: order of modifiers
________________________________________
CATEGORIES:
1. PRICING modifiers (eg.,21, 22, 26, 50, 52, 53, 60, 62, 80, 82, P1-P6)

2. PAYMENT Eligible Modifier* (eg. 24, 25, 51, 57, 58, 59, 76, 77, 78, 79, 91)
(*presence communicates special situation that might otherwise not be paid
without the modifier based on billing/coding principles and global surgery guidelines)

3. LOCATION Modifiers E1-E4, FA, F1-F9, LC, LD, LT, RC, RT, TA, T1-T9

ORDER OF REPORTING:

- Pricing modifiers before payment modifiers and location modifiers EXCEPT when global surgery package involved, then report payment modifiers before pricing. Example modifier 78 and 62.
- Payment eligible modifiers before location modifiers
- Location modifiers are always last

If you have two pricing modifiers, the most common scenario is likely to involve 26 and another modifier. Always add 26 before any other modifier.

If you have two payment modifiers, a common one is 51 and 59, enter 59 in the first position. If 51 and 78, enter 78 in the first position.

Thanks,
Chastity Nault, CPC



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