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Thread: Proper Modifier Sequencing

  1. #1
    Join Date
    Apr 2007
    St. Louis

    Default Proper Modifier Sequencing

    AAPC: Back to School
    I am sure that we are supposed to place the numeric modifier (level 1) before any other modifier (IE: LT, RT), but I cannot locate anything on the internet to confirm this.

    Does anybody know where I can look or have the info?

    Lisa Merrell, CPC, CPC-H, CPC-P

  2. #2
    Join Date
    Apr 2007
    Louisville, KY


    Modifier sequencing generally requires that those affecting reimbursement (e.g., 78, 79, 59 etc) are listed prior to informational mods (e.g., LT, GC, LD). You might look under some old billing manuals (Claim Processing Manuals, maybe) from the payer side. When I took courses in coding, some billing items (like this info.) was taught along side it; just something I retained, though I have no specific source for that information.

    Hope this helps. You are correct.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  3. #3
    Join Date
    Apr 2007
    Columbus, OH


    We always tell providers to put the pricing mods first, but I don't know of a reference for it either. (Usually the fact their claim rejected when they billed it the other way was a good enough clue for them.)
    Amy Crego, CPC, CPC-P
    Treasurer, Columbus AAPC

    One can never consent to creep when one feels an impulse to soar. ~ Helen Keller

  4. #4


    Select payer systems have a requirement that the pricing modifiers be sequenced first. For example, the payer system can accept up to four modifiers on a line but use only the first two for actual pricing and adjudication. Contact your payer; since they use difference claims processing platforms, the rules can vary greatly.

  5. #5
    Join Date
    Apr 2007
    Portsmouth Virginia

    Thumbs up Level I modifiers first

    according to 3M CCE (our coding and reimbursement system), sequence Level I modifiers first then Level II modifiers; if you have two Level I modifiers, sequence the lower number first for example 50,59.

    Melanie R. Daugherty, CPC, CPC-H, CPC-P
    Coder, Ambulatory Procedure Department
    Naval Medical Center Portsmouth
    Portsmouth, Virginia

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