HCPCS Level II-Modifiers

Question 1

E1

Answer 1

Upper left, eyelid

Question 2

E2

Answer 2

Lower left, eyelid

Example: Append E2 to CPT code 67700 when a blepharotomy, drainage of abscess, of the left lower eyelid is performed.

Question 3

E3

Answer 3

Upper right, eyelid

Question 4

E4

Answer 4

Lower right, eyelid

Question 5

HCPCS Level II Modifiers

Answer 5

• Many more than CPT modifiers
• two-character codes that may be two alphabetic characters (AA) or one alphabetic and one numeric character (U4)

***Are required to add specificity to CPT procedure codes performed on EYELIDS, FINGERS, TOES, and CORONARY ARTERIES.

-specific to HCPCS Level II codes

Question 6

BO

Answer 6

Orally Administered Nutrition, Not by Feeding Tube

Example: Append modifier BO to enteral nutrients (B4149-B4162) when administered orally [by mouth].

Question 7

F1

Answer 7

Left Hand, Second Digit

Example: Append F1 to CPT code 26340 when manipulation, finger joint, under anesthesia, each joint is performed on the second digit of the left hand.

Question 8

GA

Answer 8

Waiver of Liability Statement Issued as Required by Payer Policy, Individual Case

Example: Append GA to CPT code when the diagnosis code does not meet medical necessity according to the Local Coverage Determination (LCD) of the MAC.

Question 9

GU

Answer 9

Waiver of Liability Statement Issued as Required by Payer Policy, Routine Notice

Note: Medicare has not yet defined the use of this modifier

Question 10

LT

Answer 10

Left Side

Example: Append LT to CPT code 24000 when an arthrotomy, elbow, including exploration, drainage, or removal of foreign body is performed on the left elbow.

Question 11

NU

Answer 11

New Equipment

Example: Append NU to HCPCS Level II code E0143 when a new walker, folding, wheeled, adjustable or fixed height is sold to a patient.

Question 12

Q6

Answer 12

Service Furnished by a Locum Tenens Physician

Example: Append Q6 to CPT code 99213 when a level III established patient office visit is provided by a locum tenens while the regular physician is absent on maternity leave.

Question 13

TC

Answer 13

Technical Component

Example: Append TC to CPT code 92081 when a visual field examination, unilateral, or bilateral, is performed by a technician in a hospital and the report is performed by an independent physician. The physician would report 92081 with modifier 26. The hospital would report the technical component of 92081.