Modifier Description Level II
AUItem furnished in conjunction with a urological, ostomy, or tracheostomy supply
AVItem furnished in conjunction with a prosthetic device, prosthetic or orthotic
AWItem furnished in conjunction with a surgical dressing
AXItem furnished in conjunction with dialysis services
AYItem or service furnished to an esrd patient that is not for the treatment of esrd
AZPhysician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment
BAItem furnished in conjunction with parenteral enteral nutrition (pen) services
BLSpecial acquisition of blood and blood products
BOOrally administered nutrition, not by feeding tube
BPThe beneficiary has been informed of the purchase and rental options and has elected to purchase the item
BRThe beneficiary has been informed of the purchase and rental options and has elected to rent the item
BUThe beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision
CAProcedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission
CBService ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable
CCProcedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CDAmcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable
CEAmcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity
CFAmcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable
CGPolicy criteria applied
CH0 percent impaired, limited or restricted
CIAt least 1 percent but less than 20 percent impaired, limited or restricted
CJAt least 20 percent but less than 40 percent impaired, limited or restricted
CKAt least 40 percent but less than 60 percent impaired, limited or restricted
CLAt least 60 percent but less than 80 percent impaired, limited or restricted
CMAt least 80 percent but less than 100 percent impaired, limited or restricted