Term
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Definition
| prolonged E/M services - when services are to the highest level and take longer than usual |
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Term
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Definition
| unusual procedural services are greater than the usual listed service. |
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Term
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Definition
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Term
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Definition
| unrelated E/M services by the same physician during a postoperative period |
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Term
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Definition
| significant, separately indentifiable E/M service by same physician on the same day of procedure or other service |
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Term
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Definition
| professional component; certain procedures are a combination of a physician component and a technical component. When the physician component is reported separately the service may be identified by -26 |
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Term
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Definition
| mandated services; example when police require rape victim to have certain tests done or when an employer requires an employee to have tests done for workers compensation. |
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Term
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Definition
| when anesthesia is done by the surgeon during the procedure. |
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Term
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Definition
| bilateral procedure done during same operative session. |
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Term
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Definition
| multiple procedures; more than one procedure is performed during the operative period. Same operation but different site. |
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Term
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Definition
| reduced services; used to indicate a service that was provided but was reduced in comparison to the full description of the service. |
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Term
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Definition
| dicontinued procedure; circumstances in which services were reduced at the direction of physician, procedure was stopped becaue of the patients condition. |
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Term
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Definition
| when one surgon preforms the surgical services and the other surgon provides the postoperative & preoperative services. -55 postoperative care. -56 preoperative care. |
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Term
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Definition
| decision for surgery = it is only added to E/M codes to indicate the day the decision to perform a surgery was made. |
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Term
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Definition
| staged or related procedure or service by the same physicain during the postoperative period. Includes original procedure. |
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Term
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Definition
| indicates that services that are usually bundled into one payment were provided as seperate services. |
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Term
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Definition
| indicates that two surgeons acted as co-surgeons. |
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Term
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Definition
| procedure performed on infants less than 4 kg |
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Term
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Definition
| repeat procedure by same physician |
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Term
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Definition
| repeat procedure by another physician |
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Term
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Definition
| return to the operating room for a related procedure during the postoperative period. |
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Term
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Definition
| unrelated procedure of service by the same physician during the postoperative period. |
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Term
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Definition
| assistant surgeon needed during surgical procedure. |
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Term
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Definition
| assistant surgeon who provides services that are less extensive than those described by modifier -80 |
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Term
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Definition
| assistant surgeon when qualifiel resident surgeon not available. |
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Term
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Definition
| reference laboratory (outside) |
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Term
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Definition
| repeat clinical diagnostic laboratory test. |
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Term
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Definition
| used only if the third-party payer does not accept the addition of multiple modifiers to a code. |
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