Billing I-AIM: a novel framework for ultrasound billing

The Ultrasound Journal

Table 2 Common CPT modifier codes, to be added after the five-digit CPT code (see Table 1)

CPT modifier	Description of modifier	Example
26	Professional component of global fee	Physician component of global fee for professional services including interpretation of diagnostic tests with separate signed report
52	Partially reduced service provided	Transvaginal ultrasound in known pregnant patient (76817, no limited code exists), but POCUS does not include all anatomic structures in the region required for billing
59	Distinct procedural service—report procedures that are distinct but have the same CPT code^a	Multiple soft tissue areas on different extremities examined for abscess vs cellulitis (76882)
76	Repeat procedure by the same physician^b	Trauma patient requiring a repeat FAST examination by an emergency physician for a change in clinical stability such as hypotension
77	Repeat procedure by another physician^c	Trauma patient requiring a repeat FAST examination by the trauma surgeon for a change in clinical stability such as hypotension

^aCPT current procedural terminology
^bSame physician—providers who are under the same group Medicare provider number on the same date of service or patient encounter
^cAnother physician—provider with a different group Medicare provider number on the same date of service or patient encounter