What is the CPT modifier for emergency?

Asked by: Amy Kutch IV  |  Last update: July 18, 2025
Score: 4.8/5 (12 votes)

Medicare requires that modifier –25 always be appended to the emergency department (ED)E/M code (99281-99285) when provided on the same date as a diagnostic medical/surgical and/or therapeutic medical/surgical procedure(s).

What is the 25 modifier used for?

The Current Procedural Terminology (CPT) definition of Modifier 25 is as follows: Modifier 25 – this Modifier is used to report an Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician or other qualified health care professional.

What is a 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.

What is a 27 modifier used for?

Modifier 27 is for hospital/outpatient facilities to use when multiple outpatient hospital Evaluation and Management (E/M) encounters occur for the same member on the same date of service. Modifier 27 is exclusive to hospital outpatient departments, including hospital emergency departments, clinics and critical care.

What is modifier 73 used for?

Modifier -73 is used by the facility to indicate that a surgical or diagnostic procedure requiring anesthesia was terminated due to extenuating circumstances or to circumstances that threatened the well being of the patient after the patient had been prepared for the procedure (including procedural pre-medication when ...

What is a Modifier in Medical Coding? CPT and HCPCS Modifiers for Beginners

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What is modifier 82 used for?

CPT Modifier 82 - CPT Modifier 82 represents assistant at surgery by another physician when a qualified resident surgeon is not available to assist the primary surgeon. This modifier is not intended for use by non-physicians assisting at surgery (e.g., Nurse Practitioners or Physician Assistants/Physician Associates).

What is a 52 modifier used for?

Modifier -52 identifies that the service or procedure has been partially reduced or eliminated at the physician's discretion. The basic service described by the procedure code has been performed, but not all aspects of the service have been performed.

What is a 24 modifier used for?

Modifier 24 is defined as an unrelated evaluation and management service by the same physician or other qualified health care professional during a post-operative period.

What is the 33 modifier used for?

Current Procedural Terminology (CPT) modifier 33 can be used when billing for ACA-designated preventive services with a commercial payer. The addition of modifier 33 communicates to a commercial payer that a given service was provided as an ACA preventive service.

What is the 55 modifier for?

POSTOPERATIVE MANAGEMENT ONLY: WHEN ONE PHYSICIAN PERFORMS THE POSTOPERATIVE MANAGEMENT AND ANOTHER PHYSICIAN HAS PERFORMED THE SURGICAL PROCEDURE, THE POSTOPERATIVE COMPONENT MAY BE IDENTIFIED BY ADDING THE MODIFIER -55 TO THE USUAL PROCEDURE NUMBER OR BY USE OF THE SEPARATE FIVE DIGIT MODIFIER CODE 09955.

What is a 22 modifier?

Modifier -22: Increased Procedural Services. This modifier is used to identify a service that requires significantly greater effort, such as increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required, than is usually needed for that procedure.

What is a 95 modifier?

-95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.

What is modifier 51 used for?

Modifier 51 Multiple Procedures indicates that multiple procedures were performed at the same session. It applies to: Different procedures performed at the same session. A single procedure performed multiple times at different sites.

What is modifier 59 used for?

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.

What is modifier 26?

• Modifier 26 is appended when a physician provides the professional component only of the global fee. and when the physician prepares a written interpretation and report. • Modifier 26 should only be appended to codes which are listed in the CMS NPFSRVF as modifier 26. appropriate.

What modifier is 23?

General Use of Modifier 23

Append Modifier 23 to an anesthesia procedure code to indicate that a procedure normally performed under local anesthesia or with a regional block required general anesthesia. Documentation shall support the reason that general anesthesia was required.

What is a 54 modifier?

Modifier 54

When a physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding this modifier to the usual procedure code.

What is modifier 58 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 the 50 modifier used for?

Use modifier 50 to report bilateral procedures performed during the same operative session by the same physician in either separate operative areas (e.g., hands, feet, legs, arms, ears) or in the same operative area (e.g., nose, eyes, breasts).

What is modifier 72?

Modifier 72: Resumed Service Post-Surgical

Modifier 72 is applied when services need to be resumed during a global period for post-operative care due to unforeseen complications.

What is modifier 62 used for?

Two surgeons. Under some circumstances, the individual skills of two or more surgeons are required to perform surgery on the same patient during the same operative session.

What is modifier 32 used for?

Lay Term. Append modifier 32 to a code to show that a third party mandated that the provider perform the service.

What is modifier 60 used for?

The CPT manual introduced modifier -60 in 2001 to allow providers to indicate when a procedure was more complex than normal due to an altered surgical field.

What modifier is 77?

CPT Modifier 77 'Repeat procedure by another physician': A physician may need to indicate that he or she repeated a service performed by another physician on the same day.