BMBankOfMedicare.comBilling University & Reimbursement Research

Modifier EY

No physician or other licensed health care provider order

Billing context

Missing order modifier; high denial risk.

Before reporting this modifier

  1. 1. Confirm the current official or licensed definition and payer acceptance.
  2. 2. Identify the exact claim circumstance the modifier communicates.
  3. 3. Make the code, setting, related services, and medical record consistent.
  4. 4. Check NCCI, global surgery, component, DME, ABN, or drug rules that apply.
  5. 5. Do not append a modifier only to force an edit override.
LessonStudy the related billing ruleOfficial sourceReview current CMS guidance

This is a workflow summary, not a licensed CPT definition or claim-specific coding instruction. Verify the code set and payer rule effective for the date of service.