| 25 | CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable… | - When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,… |
| P5 | Modifier P5 denotes a moribund patient who is not expected to survive without the operative procedure and is used only with anesthesia CPT codes 00100–01999. The anesthesia provider must append P5… | - Use modifier P5 only when the anesthesia provider determines the patient is moribund and not expected to survive without the operation, and append it only to anesthesia CPT codes 00100–01999… |
| 63 | Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes… | - Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to… |
| 92 | Modifier 92 (Alternative Laboratory Platform Testing) is used when laboratory tests are performed with single‑use, disposable, portable kits or transportable instruments. The AMA defines it for tests… | - Use modifier 92 when a laboratory test is performed using a single‑use, disposable analytical device or kit (an alternative laboratory platform) that is portable and may be taken to or near the… |
| 3P | The CPT Category II modifier -3P denotes a performance‑measure exclusion when a required quality action was not performed because of system‑level constraints. It is appended only to Category II… | - When to apply: Use CPT Category II modifier 3P only with Category II (‘‘F’’) codes when a specific quality measure’s specifications allow a system‑level exclusion — append 3P to indicate the… |