Modifier Edit Code

2013-03-10

...

2.7Jan2011

2.7.1Jul2012

2.8Mar2014

...

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

LengthNot specified

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

22 components


1	O	-	Identifier
2	O	-	Text
3	C		Name of Coding System
4	O	-	Alternate Identifier
5	O	-	Alternate Text
6	C		Name of Alternate Coding System
7	C	-	Coding System Version ID
8	O	-	Alternate Coding System Version ID
9	O	-	Original Text
10	O	-	Second Alternate Identifier
11	O	-	Second Alternate Text
12	C		Name of Second Alternate Coding System
13	O	-	Second Alternate Coding System Version ID
14	C	-	Coding System OID
15	O	-	Value Set OID
16	C	-	Value Set Version ID
17	C	-	Alternate Coding System OID
18	O	-	Alternate Value Set OID
19	C	-	Alternate Value Set Version ID
20	C	-	Second Alternate Coding System OID
21	O	-	Second Alternate Value Set OID
22	C	-	Second Alternate Value Set Version ID