HCPCS Modifiers

HCPCS Modifiers are used to provide additional information regarding services, supplies, and procedures. Some payers may require the use of CPT and Level II HCPCS modifiers on claims. HCPCS Level II modifiers consist of either two letters or one letter and one number (Valerius, Bayes, Newby, & Seggern, p. 194). A. Portable home oxygen unit – This would be modifier QM. This modifier was chosen because a portable home oxygen unit is a service provided under arrangement by a provider of services. B. Emergency ambulance transport and extended life support- The modifier chosen for this is QN. Emergency ambulance transport and extended life support was furnished directly by a provider of services. C. Diagnostic mammogram, left breast- The modifier chosen for this is GG. The diagnostic mammogram, left breast is the performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day. D. Cortisone 10 mg injection, right shoulder- The modifier chosen is RT.

The cortisone injection was on the right side. Service was provided to the right side of the body. E. Nonelectric Wheelchair- This modifier would be GY because it is an item or service statutorily excluded or does not meet the definition of any Medicare benefit. F. Intravenous catheter line, right arm- The modifier is RT because the procedure was performed on the right side of the body. G. Laboratory certification, cytology specimens- Modifier is TC since the procedure is a technical component provided by a laboratory. H. Chest X-ray- The modifier used is TC since the chest x-ray is a technical procedure. I. Prosthetic hip replacement, left side- The modifier is LT because the procedure was done on the left side of the body. J. Electric hospital bed- I am going to say the modifier is CA because this is usually only provided to an inpatient setting except in specific physician orders.