Asuris Northwest Health - For Providers

Policy Name	Date Modified
Modifier -22; Increased Procedural Services	2/2012
Modifier -25; Significant, Separately Identifiable Service	02/2012
Modifier -26; Professional Component Modifier -TC; Technical Component	07/2009
Modifier -50; Bilateral Procedure	07/2009
Modifier -51 and Multiple Procedure Logic	11/2008
Modifier 53; Discontinued Procedure	11/2008
Modifier 54; Surgical Care Only; Modifier -55; Postoperative Management Only; Modifier -56; Preoperative Management Only	07/2009
Modifier -57; Decision for Surgery	11/2008
Modifier -59; Distinct Procedural Service	04/2012
Modifier -62; Two Surgeons/Co-Surgeons	08/2009
Modifier -63; Procedure Performed on Infants Less Than 4 kg	08/2009
Modifier -66; Surgical Team	08/2009
Modifier -78; Unplanned Return to the Operating/Procedure Room By the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period	08/2009
Modifiers -80, -81, -82, -AS; Assistant at Surgery	09/2010


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