Term
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Definition
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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
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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
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unrelated E/M services by the same physician during a postoperative period
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Term
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Definition
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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
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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
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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
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when anesthesia is done by the surgeon during the procedure.
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Term
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Definition
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bilateral procedure done during same operative session.
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Term
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Definition
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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
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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
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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
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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
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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
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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
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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
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indicates that two surgeons acted as co-surgeons.
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Term
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Definition
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procedure performed on infants less than 4 kg
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Term
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Definition
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repeat procedure by same physician
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Term
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Definition
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repeat procedure by another physician
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Term
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Definition
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return to the operating room for a related procedure during the postoperative period.
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Term
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Definition
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unrelated procedure of service by the same physician during the postoperative period.
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Term
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Definition
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assistant surgeon needed during surgical procedure.
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Term
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Definition
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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
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assistant surgeon when qualifiel resident surgeon not available.
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Term
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Definition
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reference laboratory (outside)
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Term
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Definition
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repeat clinical diagnostic laboratory test.
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Term
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Definition
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used only if the third-party payer does not accept the addition of multiple modifiers to a code.
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