01610
Modifier Edit Code
2007-10-26
Definition: This field contains calculated edits of the modifiers for each line or HCPCS/CPT. This field can be repeated up to five times, one edit for each of the modifiers present. This field relates to the values in PR1-16 - Procedure Code Modifier. Each repetition corresponds positionally to the order of the PR1-16 modifier codes. If no modifier code exists, use the code "U" (modifier edit code unknown) as a placeholder. The repetitions of Modifier Edit Codes must match the repetitions of Procedure Code Modifiers. For example, if PR1-16 - Procedure Code Modifier reports ...|01~02~03~04|... as modifier codes, and modifier code 03 modifier status code is unknown, GP2-8 - Modifier Edit Code would report ...|1~1~U~1|... Refer to User-defined table 0467 - Modifier Edit Code for suggested values. This field is defined by CMS or other regulatory agencies
Length≤1
6 values
0 | Modifier does NOT exist |
1 | Modifier present, no errors |
2 | Modifier invalid |
3 | Modifier NOT approved for ASC/HOPD use |
4 | Modifier approved for ASC/HOPD use, inappropriate for code |
U | Modifier edit code unknown |