Applying Level II HCPCS ModifiersAllison BensonHCR 2206/20/20131.
Portable home oxygen unita.
QM- is authorized by provider of services that a patient has to take home withhim2.
Emergency ambulance transport and extended life supporta.
QN- ambulance service that has been furnished by a provider of services thattransports a patient upon the request of the provider 3.
Diagnostic mammogram, left breasta.
GG- show the performance of a screening mammogram of the left breast of a patient4.
Cortisone 10 mg injection, right shoulder a.
RT- right side identifies a procedure that has been performed on the right side of the body5.
Nonelectric wheelchair a.
GY- item or service statutorily excluded does not meet the definition of beingcovered by any Medicare benefit6.
Intravenous catheter line, right arma.
RT- right arm identifies the right side of the body7.
Labaratory certification, cytology specimensa.
TC- this is a procedure that has to be done on the patient by using technicalequipment8.
Injection on the left hand thumb: FAI chose this modifier because the injection occurred on the left hand thumb.Emergency ambulance transport and extended life support arranged for by the provider: QN I used this because emergency ambulance transport and extended life support was given directly by a provider of services.Diagnostic mammogram, left breast: GG This modifier code was chosen because a mammogram was performed, and using this code described a code for left side. Cortisone 10 mg injection, right shoulder: RT I chose this modifier code because the procedure was performed on the right side (shoulder) of the body.Nonelectric wheelchair: GYI chose this Modifier code because the equipment was not covered by Medicare benefits. Intravenous catheter line, right arm: RTI used this code because the Intravenous catheter procedure was performed on the right side of the body.Laboratory certification, cytology specimens: TC I chose this code because the procedure performed was by using technical equipment.