| 26 | Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical… | - Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a… |
| 78 | CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a… | - Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the… |
| 1P | Modifier 1P is a Category II performance measure exclusion modifier used to indicate that a patient’s medical condition prevented performance of the action specified by a Category II quality measure… | - Use modifier 1P only with Category II (quality reporting) codes when the specific measure’s reporting instructions explicitly allow a medical-reason exclusion; it marks the patient as medically… |
| 32 | Modifier 32 (Mandated Services) indicates that a CPT-coded service was required by a third party—such as an insurer, school, state agency, or court. The AMA defines it as denoting services mandated… | - Use Modifier 32 when a service or procedure was explicitly mandated by a third party (for example an insurer requiring a second opinion, a school requiring a sports physical, a state agency or… |
| 23 | Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia… | - Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of… |