Common Modifiers Used in Surgical Oncology Procedures

In Alphabetical Order | In Numerical Order

In Alphabetical Order

-80 Assistant surgeon
-82 Assistant surgeon (when qualified resident surgeon not available)
-50 Bilateral procedure - Used to indicate bilateral procedures performed
during the same operative session. The code with modifier 50 should be billed only once on the claim.
-59 Distinct Procedural Service - Use under certain circumstances where the
physician may need to indicate that a procedure is distinct or independent
from other services performed on the same day, same provider and are not
normally reported together but are appropriate under the circumstances.
-81 Minimum assistant surgeon
-51 Multiple procedures - not required for billing purposes. The carrier will
assign the multiple procedure modifier as appropriate based on the services billed.
-55 Post-operative care only - Use with surgical codes to indicate that only the post-operative care is performed (another physician performed the surgery)
-56 Pre-operative care only - DO NOT USE FOR MEDICARE PURPOSES -
Payment for this component is included in the allowable for surgery. If
another physician performed the surgery, use an appropriate E/M code to bill
the pre-op service.
-52 Reduced Services - Use for reporting services that were partially reduced or
eliminated at the physician's election. Documentation should be furnished
explaining the reduction.
-77 Repeat procedure - same day, different physician
-76 Repeat procedure by same physician - same day
-78 Return to the operating room for a related procedure during the postoperative period - Use on surgical codes only. Failure to use modifier when appropriate may result in denial of the subsequent surgery
-79 Return to the operating room for an unrelated procedure during the
postoperative period - Use on surgical codes only.
-58 Staged or related procedure or service during the postoperative period - This modifier should be used to permit payment for a surgical procedure during the postoperative period of another surgical procedure when (1) the subsequent procedure was planned prospectively at the time of
the original procedure, (2) a less extensive procedure fails and a more
extensive procedure is required or (3) a therapeutic surgical procedure
follows a diagnostic procedure; e.g., a mastectomy follows a breast biopsy.
Failure to use modifier when appropriate may result in denial of subsequent surgery
-54 Surgical care only - Use with surgical codes when only the surgical service
was performed (another physician is responsible for the pre- and/or
postoperative management).
-66 Surgical team - The modifier should be used by each participating surgeon
to report his services.
-53 Terminated procedure without complications- for procedures terminated in respect to the patient's condition
-62 Two surgeons - When more than one surgeon performed a procedure, the
modifier should be used by each surgeon to report his/her services.
-22 Unusual procedural services - Used only on surgery codes. An operative
note should be submitted with the claim. Used to indicate that services
provided were greater than those usually required. Determination requires documentation. "This case was more difficult because …



In Numerical Order

-22
Unusual procedural services - Used only on surgery codes. An operative
note should be submitted with the claim. Used to indicate that services
provided were greater than those usually required. Determination requires
documentation. "This case was more difficult because….
-50 Bilateral procedure - Used to indicate bilateral procedures performed
during the same operative session. The code with modifier 50 should be
billed only once on the claim.
-51 Multiple procedures - not required for billing purposes. The carrier will
assign the multiple procedure modifier as appropriate based on the services
billed.
-52 Reduced Services - Use for reporting services that were partially reduced
or eliminated at the physician's election. Documentation should be furnished explaining the reduction.
-53 Terminated procedure without complications- for procedures
terminated in respect to the patient's condition
-54 Surgical care only - Use with surgical codes when only the surgical service
was performed (another physician is responsible for the pre- and/or
postoperative management).
-55 Post-operative care only - Use with surgical codes to indicate that only
the post-operative care is performed (another physician performed the
surgery)
-56 Pre-operative care only - DO NOT USE FOR MEDICARE PURPOSES - Payment for this component is included in the allowable for surgery. If another physician performed the surgery, use an appropriate E/M code to bill the pre-op service.
-58 Staged or related procedure or service during the postoperative eriod - This modifier should be used to permit payment for a surgical rocedure during the postoperative period of another surgical procedure hen (1) the subsequent procedure was planned prospectively at the time f the original procedure, (2) a less extensive procedure fails and a more extensive procedure is required or (3) a therapeutic surgical procedure
follows a diagnostic procedure; e.g., a mastectomy follows a breast biopsy.
Failure to use modifier when appropriate may result in denial of subsequent urgery
-59 Distinct Procedural Service - Use under certain circumstances where the
physician may need to indicate that a procedure is distinct or independent
from other services performed on the same day, same provider and are not
normally reported together but are appropriate under the circumstances.
-62 Two surgeons - When more than one surgeon performed a procedure, the
modifier should be used by each surgeon to report his/her services.
-66 Surgical team - The modifier should be used by each participating surgeon
to report his services.
-76 Repeat procedure by same physician - same day
-77 Repeat procedure - same day, different physician
-78 Return to the operating room for a related procedure during the postoperative period - Use on surgical codes only. - Failure to use modifier when appropriate may result in denial of the subsequent surgery
-79 Return to the operating room for an unrelated procedure during the
postoperative period - Use on surgical codes only.
-80 Assistant surgeon
-81 Minimum assistant surgeon
-82 Assistant surgeon (when qualified resident surgeon not available)
* Please consult the current edition of the AMA's CPT Manual for more detailed information on these and all other CPT codes.