This modifier is used to override restrictions for a service/procedure.
Code: | Description: |
---|---|
DSCH | DISCHARGED Explicit As stated in GR 5.1.4, indicates payment for a patient who was discharged from an emergency department, AACC or UCC and returned the same day. |
L40 | UNDER 40 WEEKS CONCEPTUAL AGE, ROLE OF SURGEON Explicit Infants under 40 weeks of conceptual age. Applies only to specific general surgery procedures. |
L40ANE | UNDER 40 WEEKS CONCEPTUAL AGE, ROLE OF ANESTHETIST Explicit |
L44 | UNDER 44 WEEKS CONCEPTUAL AGE, ROLE OF SURGEON Explicit Infants under 44 weeks of conceptual age. Applies only to cardiovascular and thoracic surgery. |
L44ANE | UNDER 44 WEEKS CONCEPTUAL AGE, ROLE OF ANESTHETIST Explicit |
NEWCON | NEW CONDITION FOR OPTOMETRY Explicit Indicates an Optometrist is providing optometric services to an eligible resident for a new condition whose diagnostic code contains the same first three-digit root as a condition previously billed in the same benefit year. |
NEWEP | NEW EPISODE FOR OPTOMETRY Explicit Indicates an Optometrist is providing optometric services to an eligible resident for a condition that was previously billed, but the resident incurred a new occurrence of the condition in the same benefit year. |
OPHTCO | OPHTHALMOLOGY CO-MANAGEMENT Explicit used to identify ongoing co-management of eye care for an eligible resident between an Optometrist and an Ophthalmologist |
SPCDRG | SPECIFIED DRUGS FOR OPTOMETRY Explicit Indicates an Optometrist is providing optometric services as the patient is receiving treatment with the drug Chloroquine (Aralen), Ethambutol (Myambutol and Servambutol), Hydroxychloroquine Sulfate (Plaquenil), or Tamoxifen (Novaldex). |
TOC | TRANSFER OF CARE Explicit Indicates the care of a hospitalized patient was transferred to a second physician in the same facility. The physician receiving the transferred patient must use TOC. |
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