Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Modifiers)
Modifiers Defined by
DHS (continued)
11-20
U6 Definition 1= Temporary Service
Increase (T1001, T1019)
Definition 2= IEP
PCA/Paraprofessional Services
(T1018)
Definition 3 = NET Taxi or equal,
wheelchair, door to door (A0100)
Definition 4 = End tidal CO2 spot
check, weekly rental (E1399)
Definition 5 = none
Definition 6 = none
Definition 7 = Parents with children
(Substance abuse treatment H2036,
H0005, H2035)
U7 Definition 1 = Physician Extender
(medical services)
Definition 2 = IEP Assistive
Technology Devices (T1018)
Definition 3 = NET Bus/train,
monthly pass (A0110)
Definition 4 = Oximeter spot check,
weekly rental (E0445)
Append the modifier
if directed to in
guidelines that may
be found elsewhere
in this manual.
Append this
modifier to services
by non-credentialed
or non-enrolled
practitioners when
performing incidentto
services under the
direct supervision.
The services would
be reported under
the directing
physician’s provider
number. The
modifier does not
impact payment.
Append the modifier
if directed to in
guidelines that may
be found elsewhere
in this manual.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (10/05/11)