- Anesthesia Modifiers
- Appropriate Usage of Modifier 99
- Assistants at Surgery at Teaching Hospitals
- Bundled Services Missing Appropriate Modifiers at Time of Initial Claim Submission
- Clarification for Billing Services on Fingers and Toes Using Modifiers F1-F9, FA, TI-T9 and TA vs. Modifier 50
- Correct Usage of Modifier 79 for Multiple Procedures
- Co-Surgery/Team Surgery/Assistant Surgery Modifiers
- Modifier 25
- Modifier 33
- Modifier 51
- Modifier 52 Claim Submission Billing Reminder
- Modifier 59 and the Subset Modifiers XE, XP, XS, XU - Specific Modifiers for Distinct Procedural Services
- Modifier 90 Reference to Outside Laboratory
- Modifiers Used in CMS-1500 Claim Reporting
- Modifier Usage
- Proper Billing of Surgical Comanagement (Modifiers 54 and 55)
- Proper Use of Modifiers 59 and 91
- Reminder for Submission of Modifier 22
- Repeat Procedures - Modifiers 76 and 77
Appropriate Usage of Modifier 99
Table of Contents
Appropriate Usage of Modifier 99
Modifier 99 indicates multiple modifiers; under certain circumstances, two or more modifiers may be necessary to completely delineate a service. In such situations, modifier 99 should be added to the basic procedure and all other applicable modifiers should be listed as part of the description for the service.
Keep in mind, modifier 99 should only be used if a single line item requires five or more modifiers.
Note: Item 24D on the CMS-1500 Claim Form or the electronic equivalent (Loop 2400, SV1 segment, data elements SV101-3, SV101-4, SV101-5 and SV101-6) accommodates the entry of up to four modifiers.
Appropriate Usage
If a single line item requires five or more modifiers, enter only modifier 99 in the first space available for modifiers in item 24D or the electronic equivalent (Loop 2400, SV1 segment, data elements SV101-3, SV101-4, SV101-5 and SV101-6).
Enter all other applicable modifiers in item 19 “Additional Claim Information,” or the electronic equivalent (Loop 2400, NTE segment, data element NTE02).
- When modifier 99 is entered on multiple line items of a single claim form, all applicable modifiers for each line item containing a 99 modifier should be listed as follows:
- 1=(mod), where the number 1 represents the line item and ‘mod’ represents all modifiers applicable to the referenced line item.
Inappropriate Usage
- Entering three different modifiers in the first three modifier fields and then 99 in the fourth.
- Reporting less than five modifiers for one line of service.
When modifier 99 is improperly used or not reported it can cause the following issues during claim processing:
- Claim denials
- Delay in processing/payment
- Improper payment
Related Content
- Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 26 - Completing and Processing Form CMS-1500 Data Set, Section 10.4
- Medicare Part B CMS-1500 Crosswalk for 5010 Electronic Claims
- CMS-1500 Claims Form Completion Instructions
Revised 9/28/2023