01316
Procedure Code Modifier
2007-05-08
Definition: This field contains the procedure code modifier to the procedure code reported in OBR-44-procedure code, when applicable. Procedure code modifiers are defined by regulatory agencies such as CMS and the AMA. Multiple modifiers may be reported. The modifiers are sequenced in priority according to user entry. In the USA, this is a requirement of the UB and the 1500 claim forms. Multiple modifiers are allowed and the order placed on the form affects reimbursement. Refer to user-defined table 0340 - Procedure code modifier for suggested values.
Usage Rule: This field can only be used if OBR-44-procedure code contains certain procedure codes that require a modifier in order to be billed or performed. For example, in the USA, HCPCS codes that require a modifier to be precise.
Length≤250
1 values
... | No suggested values | Deprecated |
6 components
| 1 | O | - | Identifier | |
| 2 | O | - | Text | |
| 3 | O | Name of Coding System | ||
| 4 | O | - | Alternate Identifier | |
| 5 | O | - | Alternate Text | |
| 6 | O | Name of Alternate Coding System |