Name of Manual - Blue Cross and Blue Shield of Minnesota

Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (10/05/11)
Coding Policies and Guidelines (Modifiers)
MOD Description Submission Guidelines Impact to Payment
-77 Repeat
Procedure by
Another
Physician
-79 Unrelated
Procedure or
Service by the
Same Physician
During Postoperative
Period
-80 Assistant
Surgeon
-81 Minimum
Assistant
Surgeon
-82 Assistant
Surgeon (When
Qualified
Resident
Surgeon Not
Available)
The practitioner may need to indicate that a
procedure or service was repeated
subsequent to the original procedure or
service on the same day. This circumstance
may be reported by adding modifier –77 to
the repeated procedure/service.
Note: In situations warranting the use of
both the –26 and –77 modifier (e.g.,
reading multiple chest X-rays of a
patient performed on the same day),
submit the –26 modifier in the first
position with the initial procedure
and the –77 in the first position for
the repeat procedure.
Append this modifier to
procedures/services performed during the
post-operative period of another procedure,
if the procedure/service is unrelated to the
original procedure.
Append this modifier to surgical assists
performed by a physician, nurse
practitioner, physician assistant, or RNFA.
Blue Cross adheres to CMS’ published list
of services eligible for surgical assist.
Append this modifier to surgical assists
performed by a physician, nurse
practitioner, physician assistant, or RNFA.
Blue Cross adheres to CMS’ published list
of services eligible for surgical assist.
Append this modifier to surgical assists
performed by a physician, nurse
practitioner, physician assistant, or RNFA.
Blue Cross adheres to CMS’ published list
of services eligible for surgical assist.
Separate payment of
the service may be
made.
Separate payment of
the service may be
made.
Payment is made at
16% of the allowed
amount.
Multiple surgery
pricing logic also
applies to assistant at
surgery services.
Payment is made at
16% of the allowed
amount.
Multiple surgery
pricing logic also
applies to assistant at
surgery services.
Payment is made at
16% of the allowed
amount.
Multiple surgery
pricing logic also
applies to assistant at
surgery services.
11-11