AMA CPT Modifier Codes - HL7 Terminology (THO) v7.0.0

HL7 Terminology (THO)
7.0.0 - UTG Consensus Review Proposal UP-780 International flag

HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

ValueSet: AMA CPT Modifier Codes

Official URL: http://terminology.hl7.org/ValueSet/cpt-modifiers		Version: 1.0.0
Active as of 2023-08-05	Responsible: Health Level Seven International	Computable Name: AmaCPTModifierCodes
Copyright/Legal: CPT © Copyright 2023 American Medical Association. All rights reserved. AMA and CPT are registered trademarks of the American Medical Association.

CPT modifiers (e.g. for Claim.item.modifier)

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

Include codes fromhttp://www.ama-assn.org/go/cpt version Not Stated (use latest from terminology server) where modifier = true

Expansion

Expansion from tx.fhir.org based on codesystem cpt version 2023

This value set contains 4 concepts

System	Code	Display (en)	JSON	XML
`http://www.ama-assn.org/go/cpt`	25	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: It may be necessary to indicate that on the day a procedure or service identified by a CPT code was performed, the patient's condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. A significant, separately identifiable E/M service is defined or substantiated by documentation that satisfies the relevant criteria for the respective E/M service to be reported (see Evaluation and Management Services Guidelines for instructions on determining level of E/M service). The E/M service may be prompted by the symptom or condition for which the procedure and/or service was provided. As such, different diagnoses are not required for reporting of the E/M services on the same date. This circumstance may be reported by adding modifier 25 to the appropriate level of E/M service. Note: This modifier is not used to report an E/M service that resulted in a decision to perform surgery. See modifier 57 For significant, separately identifiable non-E/M services, see modifier 59.
`http://www.ama-assn.org/go/cpt`	P1	A normal healthy patient
`http://www.ama-assn.org/go/cpt`	1P	Performance Measure Exclusion Modifier due to Medical Reasons Reasons include: Not indicated (absence of organ/limb, already received/ performed, other) Contraindicated (patient allergic history, potential adverse drug interaction, other) Other medical reasons
`http://www.ama-assn.org/go/cpt`	F1	Left hand, second digit

Explanation of the columns that may appear on this page:

Level

A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies

System

The source of the definition of the code (when the value set draws in codes defined elsewhere)

Code

The code (used as the code in the resource instance)

Display

The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application

Definition

An explanation of the meaning of the concept

Comments

Additional notes about how to use the code

History

Date

Action

Custodian

Author

Comment

2023-11-14

revise