Can you use two modifiers on one CPT code?
Asked by: Derick Dare | Last update: August 1, 2025Score: 4.1/5 (33 votes)
How many modifiers can be used for one procedure?
If appropriate, more than one modifier may be used with a single procedure code; however, are not applicable for every category of the CPT codes. Some modifiers can only be used with a particular category and some are not compatible with others.
Can you use modifier 59 twice on one claim?
Don't report CPT code 97750 with modifier 59 if you perform 2 procedures during the same time block. You may report modifier 59 when you perform 2 timed procedures in 2 different blocks of time on the same day.
Can you use both modifiers 25 and 57?
Both Major and Minor Surgeries on the Same Day When a decision for surgery includes both major and minor surgeries and is made the day of surgery, the E&M billed for the decision must have both modifier –57 and modifier –25 appended.
Can RT and LT modifiers be used together?
Do not use the combination RTLT modifier on the same claim line and bill with 2 UOS. Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and/or LT modifiers or with the RTLT on a single claim line, will be rejected as incorrect coding.
What is a Modifier in Medical Coding? CPT and HCPCS Modifiers for Beginners
Can a CPT have multiple modifiers?
CPT modifiers are added to the end of a CPT code with a hyphen. In the case of more than one modifier, you code the “functional” modifier first, and the “informational” modifier second.
What are the two types of modifiers that can be combined?
Modifiers give additional information about nouns, pronouns, verbs, and themselves to make those things more definite. There are two types of modifiers: adjectives and adverbs.
Can modifier 24 and 57 be billed together?
Modifier 57 is used to indicate that an E/M service resulted in the decision for surgery, while modifier 24 is used for unrelated E/M services during the postoperative period. These modifiers address different situations and should not be used simultaneously.
Can you use modifier 59 and RT together?
You can only use modifier 59 or an X modifier if no other modifier describes the relationship between the two codes you're trying to bill together. That may be modifier 25, RT, 58 or many others, depending on the circumstances.
What is the CMS rule for modifier 25?
Use modifier 25 (same-day significant, separately identifiable E/M service) on the claim when you report critical care services unrelated to the service or procedure that you perform on the same day. You must also document the medical record with the relevant criteria for the respective E/M service you're reporting.
Can modifier 25 be used twice?
Yes, you can add modifier 25 to CPT code 99214 if a significant, separately identifiable E/M service is performed on the same day as another procedure.
What is the modifier 59 rule?
For the NCCI, the primary purpose of CPT® modifier 59 is to indicate that two or more procedures are performed at different anatomic sites or during different patient encounters. It should only be used if no other modifier more appropriately describes the relationships of the two or more procedure codes.
When using multiple modifiers in what order are they sequenced?
The proper sequencing order for modifiers is as follows: 1) pricing, 2) payment, and 3) location. Location modifier is always reported last in any coding scenario. Modifiers 26 and TC are examples of pricing modifiers while modifiers 51 and 59 are examples of payment. RT and LT are examples of location modifiers.
What are modifier rules?
Modifier Basics
A modifier is a word, phrase, or clause that modifies—that is, gives information about—another word in the same sentence. For example, in the following sentence, the word "burger" is modified by the word "vegetarian": Example: I'm going to the Saturn Café for a vegetarian burger.
What is the 57 modifier used for?
CPT modifier 57 may be used to report the decision for surgery for certain codes. This modifier may be used to indicate that an evaluation and management (E/M) service performed on the same day or the day before a major surgery (090 global days) by the surgeon resulted in the decision to perform the procedure.
Can modifier 59 be used twice on same claim?
Billing Reminders
Bill all services performed on one day on the same claim. Report each service on a separate line. Append 59 to the subsequent procedures (if applicable). More than one line with modifier 59 appended to the same procedure code requires submission of supporting information/documentation on the claim.
How are modifiers shown in CPT?
The most common CPT modifiers are nominated by letters or numbers. For example, the modifier -22 indicates increased services, while -52 means reduced fees. Other modifiers include -59 for distinct procedural service, -95 for telehealth, and -96 -97 for habilitative and rehabilitative services, respectively.
Can RT and LT modifier be used together?
“When the same code for bilateral items (left and right) is billed on the same date of service, bill each item on two separate claim lines using the RT and LT modifiers and one unit of service (UOS) on each claim line,” the agency says. “Do not use the RTLT modifier on the same claim line and billed with 2 UOS.
Can you use both modifier 25 and 57?
These modifiers can be used separately, though Good also details certain situations in which both can be used together to accurately represent the services provided.
What is a 58 modifier used for?
Modifier 58 is defined as a staged or related procedure performed during the postoperative period of the first procedure by the same physician. A new postoperative period begins when the staged procedure is billed.
What is an inappropriate use of the 57 modifier?
Inappropriate Uses
Appending to an E/M procedure code performed the same day as a minor surgery. When the decision to perform a minor procedure is done immediately before the service, it is considered a routine preoperative service and not billable in addition to the procedure.
What is the difference between a specifier and modifier?
Access Specifier is used to provide your code in Java whether other classes can access your code or not. Access Modifier provides both Access Specifier and Access Modifiers for creating access to your Java code for other classes.
What is the rule for compound modifiers?
Conventionally, and with the support of modern writing guides, compound modifiers that appear before a noun phrase should include a hyphen between each word, subject to certain exceptions.
Which modifier is used to show multiple modifiers?
Modifier 51 Multiple Procedures indicates that multiple procedures were performed at the same session. It applies to: Different procedures performed at the same session.