New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 52 - HOSPITAL SERVICES MANUAL
Subchapter 10 - CENTERS FOR MEDICARE & MEDICAID SERVICES HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) FOR HOSPITAL OUTPATIENT LABORATORY SERVICES
Section 10:52-10.5 - Pathology and Laboratory HCPCS Codes-Modifiers
Universal Citation: NJ Admin Code 10:52-10.5
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Services and procedures may be modified under certain circumstances. When applicable, the modifying circumstance has been identified by the addition of alphabetic and/or numeric characters at the end of the code. The New Jersey Medicaid/NJ FamilyCare fee-for-service programs' recognized modifier codes are:
| Modifier | |
| Code | Description |
| 22 | Unusual Procedural Services: When the service(s) provided |
| is greater than that usually required for the listed | |
| procedure, it may be identified by adding modifier '22' | |
| to the usual procedure number. A report may also be | |
| appropriate. | |
| 26 | Professional Component: Certain procedures are a |
| combination of a physician component and a technical | |
| component. When the physician component is reported | |
| separately, the service may be identified by adding the | |
| modifier '26' to the usual procedure number. | |
| 52 | Reduced Services: Under certain circumstances a service |
| or procedure is partially reduced or eliminated at the | |
| physician's election. Under these circumstances the | |
| service provided can be identified by its usual procedure | |
| number and the addition of the modifier '52', signifying | |
| that the service is reduced. This provides a means of | |
| reporting reduced services without disturbing the | |
| identification of the basic service. | |
| 90 | Reference (Outside) Laboratory: When laboratory |
| procedures are performed by a party other than the | |
| treating or reporting physician, the procedure may be | |
| identified by adding the modifier '90' to the usual | |
| procedure number. |
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