Coding Reference
Medical Billing Modifier Reference
Plain-language workflow summaries for professional, NCCI, component, repeat-service, postoperative, laboratory, drug, and DMEPOS modifiers.
Learn modifiers by workflow
DME Rental, Purchase, Replacement, and Repair Modifiers
Connect equipment status and the rental month to the item, order, delivery, payment category, repair record, and claim history.
NU · RR · UE · KH · KI · KJ · RA · RB · MSMedical Necessity and Beneficiary Liability Modifiers
Separate policy attestation, missing-order facts, statutory exclusions, and notice-of-liability workflows.
KX · GA · GX · GY · GZ · EYRepeat Service and Professional or Technical Component Modifiers
Distinguish a repeat service from a professional or technical component and from an accidental duplicate claim.
26 · TC · 76 · 77 · 91NCCI Distinct Procedural Service Modifiers
Apply an NCCI-associated modifier only when the clinical and procedural facts establish a genuinely distinct service.
59 · XE · XP · XS · XUJW and JZ Drug Discarded-Amount Modifiers
Report an applicable discarded amount or no discarded amount under the current Medicare Part B drug policy.
JW · JZLaterality and Supply Relationship Modifiers
Report side or the relationship of a supply to a related benefit only when the code and payer instructions require it.
RT · LT · AU · AV · AWIndividual modifier reference
24Unrelated E/M during a postoperative periodReports a separately supported E/M service by the same professional during a postoperative period; verify the current licensed code definition and payer rule.Open reference25Separate E/M work on the same dayReports a significant, separately supported E/M service on the same day as another service; the record must support work beyond the usual associated service.Open reference26Professional componentIdentifies the professional component when professional and technical components may be billed separately.Open reference50Bilateral procedureReports a bilateral procedure when the code and payer processing rules permit this method.Open reference51Multiple proceduresCommunicates multiple procedures in a session when applicable; payer systems may apply this automatically or require another method.Open reference52Reduced serviceIndicates that a service was partially reduced or eliminated under circumstances supported by the record.Open reference53Discontinued procedureIndicates that a procedure was started and discontinued for a supported patient-safety or clinical reason.Open reference57Decision for surgeryIdentifies an E/M service that resulted in the initial decision for major surgery under applicable global-surgery rules.Open reference58Staged or related postoperative procedureReports a staged, planned, more extensive, or therapy-following procedure during a postoperative period when applicable.Open reference59Distinct procedural serviceUsed only when services that normally edit together are distinct under documented circumstances and no more specific modifier applies.Open reference76Repeat procedure by the same professionalReports a medically necessary repeat service by the same physician or qualified professional when supported.Open reference77Repeat procedure by another professionalReports a medically necessary repeat service by a different physician or qualified professional when supported.Open reference78Related return during postoperative periodReports a related unplanned return to an operating or procedure room during the postoperative period when applicable.Open reference79Unrelated postoperative procedureReports a procedure unrelated to the original surgery during the postoperative period when supported.Open reference90Reference laboratory serviceReports a laboratory test performed by an outside or reference laboratory when applicable.Open reference91Repeat clinical diagnostic laboratory testReports a medically necessary repeat laboratory test, not a repeat caused by specimen or equipment problems or simple confirmation.Open referenceTCTechnical componentIdentifies the technical component when professional and technical portions may be reported separately.Open referenceXESeparate encounterNCCI-associated modifier for a service distinct because it occurred during a separate encounter.Open referenceXPSeparate practitionerNCCI-associated modifier for a service distinct because it was performed by a different practitioner.Open referenceXSSeparate structureNCCI-associated modifier for a service distinct because it was performed on a separate organ or structure.Open referenceXUUnusual non-overlapping serviceNCCI-associated modifier for a service that does not overlap the usual components of the main service.Open referenceJWDiscarded drug amountReports an applicable discarded amount from a single-dose container or package under current payer drug-wastage rules.Open referenceJZNo discarded drug amountReports that no amount was discarded from an applicable single-dose container or package under current payer rules.Open referenceNUNew equipmentUsed when billing new equipment where applicable.Open referenceRRRentalUsed for rental billing where applicable.Open referenceUEUsed durable medical equipmentUsed equipment modifier where applicable.Open referenceKXRequirements specified in medical policy have been metRequires supplier confidence that applicable policy requirements are satisfied.Open referenceGAWaiver of liability statement issuedUsed when an ABN may apply.Open referenceGXVoluntary notice of liability issuedUsed for a voluntary notice under payer policy when applicable.Open referenceGYItem or service statutorily excludedUsed for statutorily excluded items or services.Open referenceGZItem or service expected to be deniedUsed where no ABN was obtained and denial is expected.Open referenceRAReplacement of DME itemReplacement modifier requiring claim-specific support.Open referenceRBReplacement part of DME item furnished as part of repairRepair part modifier where applicable.Open referenceRTRight sideLaterality modifier.Open referenceLTLeft sideLaterality modifier.Open referenceEYNo physician or other licensed health care provider orderMissing order modifier; high denial risk.Open referenceKHInitial claim, purchase or first rental monthDME rental/purchase sequence modifier.Open referenceKISecond or third month rentalDME rental sequence modifier.Open referenceKJFourth to fifteenth month rentalDME rental sequence modifier.Open referenceMSSix month maintenance and servicing feeMaintenance and servicing modifier.Open referenceCGPolicy criteria appliedPolicy criteria modifier where applicable.Open referenceAUItem furnished in conjunction with urological, ostomy, or tracheostomy supplySupply relationship modifier where applicable.Open referenceAVItem furnished in conjunction with a prosthetic deviceProsthetic relationship modifier where applicable.Open referenceAWItem furnished in conjunction with surgical dressingSurgical dressing relationship modifier where applicable.Open reference
CPT modifier content is maintained by the American Medical Association. Use a current licensed code set and payer-specific instructions; these summaries do not replace official definitions.