Modifier 99 | Multiple Modifiers Explained

Modifier 99 indicates multiple modifiers associated with a procedure or service.

1. What is modifier 99?

Modifier 99 describes a situation where two or more additional modifiers apply to a service or procedure, but there is not enough space to list them all. In such cases, modifier 99 is the first modifier to the procedure or service.

2. When to use modifier 99?

Modifier 99 is used when there are not enough spaces in the computer system, or the payer’s computer system, to hold all modifiers associated with the procedure. Most systems can accommodate at least two or three modifiers.

If a claim requires more than three modifiers, the payer may require you to list the actual modifiers in block 19 or the appropriate electronic space for additional information.

3. Description

The official description of modifier 99 is “multiple modifiers”.

4. Examples

Examples of procedures that may require modifier 99 include complex surgeries that involve multiple procedures, such as a laparoscopic cholecystectomy with intraoperative cholangiogram and common bile duct exploration.

5. Documentation

Documentation requirements for using modifier 99 include ensuring that all applicable modifiers are documented in the medical record and that the medical record supports modifier 99.

6. Billing

To bill for a procedure or service with multiple modifiers, append modifier 99 as the first modifier, followed by all other applicable modifiers. Some payers may require you to list modifier 99 in the modifier field of block 24D of the CMS 1500 form and list all other modifiers in block 19 with the appropriate code.

7. Common mistakes

Medical coders make common mistakes when using modifier 99, including failing to document all applicable modifiers in the medical record and failing to follow individual payer guidelines for reporting multiple modifiers.

To avoid these mistakes, check with individual payers to determine their guidelines for reporting multiple modifiers and ensure all documentation is complete and accurate.

8. Other modifiers related to modifier 99

Other modifiers related to modifier 99 include modifier 22 (increased procedural services), modifier 25 (significant, separately identifiable evaluation and management service by the same physician or other qualified healthcare professional on the same day of the procedure or other service), and modifier 59 (distinct procedural service).

9. Tips

When using modifier 99, ensure all documentation is complete and accurate, and follow individual payer guidelines for reporting multiple modifiers.

It is also helpful to keep up-to-date with reporting guideline changes and seek clarification from payers when necessary.

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