American Medical Association - CPT 2021 Professional Edition

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Table of Contents

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Symbols

Revised code
New code
New or revised text
Reference to CPT Assistant, Clinical Examples in Radiology, and CPT Changes
Add-on code
Exemptions to modifier 51
Product pending FDA approval
#	Out-of-numerical sequence code
Telemedicine
	Duplicate PLA test
Category I PLA

Modifiers (See for definitions)

	Increased Procedural Services
	Unusual Anesthesia
	Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
	Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
	Professional Component
	Mandated Services
	Preventive Services
	Anesthesia by Surgeon
	Bilateral Procedure
	Multiple Procedures
	Reduced Services
	Discontinued Procedure
	Surgical Care Only
	Postoperative Management Only
	Preoperative Management Only
	Decision for Surgery
	Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
	Distinct Procedural Service
	Two Surgeons
	Procedure Performed on Infants less than 4 kg
	Surgical Team
	Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
	Repeat Procedure by Another Physician or Other Qualified Health Care Professional
	Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
	Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
	Assistant Surgeon
	Minimum Assistant Surgeon
	Assistant Surgeon (when qualified resident surgeon not available)
	Reference (Outside) Laboratory
	Repeat Clinical Diagnostic Laboratory Test
	Alternative Laboratory Platform Testing
	Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System
	Habilitative Services
	Rehabilitative Services
	Multiple Modifiers

Category II Modifiers

1P	Performance Measure Exclusion Modifier due to Medical Reasons
2P	Performance Measure Exclusion Modifier due to Patient Reasons
3P	Performance Measure Exclusion Modifier due to System Reasons
8P	Performance measure reporting modifieraction not performed, reason not otherwise specified

Anesthesia Physical Status Modifiers

P1	A normal healthy patient
P2	A patient with mild systemic disease
P3	A patient with severe systemic disease
P4	A patient with severe systemic disease that is a constant threat to life
P5	A moribund patient who is not expected to survive without the operation
P6	A declared brain-dead patient whose organs are being removed for donor purposes

Modifiers Approved for Hospital Outpatient Use
Level I (CPT)

	Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
	Multiple Outpatient Hospital E/M Encounters on the Same Date
	Preventive Services
	Bilateral Procedure
	Reduced Services
	Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
	Distinct Procedural Service
	Discontinued Outpatient Procedure Prior to Anesthesia Administration
	Discontinued Outpatient Procedure After Anesthesia Administration
	Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
	Repeat Procedure by Another Physician or Other Qualified Health Care Professional
	Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
	Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
	Repeat Clinical Diagnostic Laboratory Test

Level II (HCPCS/National)

LT	Left side (used to identify procedures performed on the left side of the body)
RT	Right side (used to identify procedures performed on the right side of the body)
E1	Upper left, eyelid
E2	Lower left, eyelid
E3	Upper right, eyelid
E4	Lower right, eyelid
FA	Left hand, thumb

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