0CTCODECIDINAMEC 7UNITADJN@ UNITADJPERNJ 25 =Significant, Separately Identifiable E&M, Same MD/Day 0 0 LT =Left Side 0 0 RT =Right Side 0 0 52 =Reduced Services 0 0 SL =STATE VACCINE 0 0 QW WCLIA waived test 0 0 21 cProlonged Evaluation and Management Services 0 0 22 cUnusual Procedural Services 0 0 23 cUnusual Anesthesia 0 0 24 cUnrelated E&M svc by the Same MD during Postop Period 0 0 26 cProfessional Component 0 0 32 cMandated Services 0 0 47 cAnesthesia by Surgeon 0 0 50 cBilateral Procedure 0 0 51 cMultiple Procedures performed on same day 0 0 53 cDiscontinued Procedure 0 0 54 cSurgical Care Only 0 0 55 cPostoperative Management Only 0 0 56 cPreoperative Management Only 0 0 57 cDecision for Surgery 0 0 58 cStaged/Related Proc/Svc Same MD during Postop Period 0 0 59 cDistinct Procedural Service 0 0 62 cTwo Surgeons 0 0 63 cProcedure Performed on Infants less than 4 kg 0 0 66 cSurgical Team 0 0 76 cRepeat Procedure by Same Physician 0 0 77 cRepeat Procedure by Another Physician 0 0 78 cReturn to OR for Related Proc During Postop Period 0 0 79 cUnrelated Proc/Svc Same MD during Postop Period 0 0 80 cAssistant Surgeon 0 0 81 cMinimum Assistant Surgeon 0 0 82 cAssist Surg when qualified resident surgeon not avail 0 0 90 cReference (Outside) Laboratory 0 0 91 cRepeat Clinical Diagnostic Laboratory Test 0 0 99 cMultiple Modifiers 0 0 E1 cUpper left eyelid 0 0 E2 cLower left eyelid 0 0 E3 cUpper right eyelid 0 0 E4 cLower right eyelid 0 0 QU cPhysician providing svc urban HPSA 0 0 QV cItem or service provided 0 0 QX cCRNA svc w/ MD med direction 0 0 QY cMedically directed CRNA 0 0 QZ cCRNA svc w/o med dir by MD 0 0 RC cRight coronary artery 0 0 RP cReplacement & repair DMEPOS 0 0 RR cRental (DME) 0 0 SA cNurse practitioner w physician 0 0 SB cNurse midwife 0 0 SC cMedically necessary service or supply 0 0 SD cService by home infusion RN 0 0 SE cState/fed funded program 0 0 SF c2nd opinion ordered by PRO 0 0 SG cASC facility service 0 0 SH c2nd concurrent infusion therapy 0 0 SJ c3rd concurrent infusion therapy 0 0 SK cHigh risk population 0 0 TC cTechnical component 0 0 27 cMultiple Outpt Hosp E&M Encounters Same Date 0 0 AS cPA, nurse pract., or clinical nurse spclst srvcs for as 0 0 MS c6 mo maint/svc fee reas/nec p/l not cvrd under warrty 0 0 NU cNew Equipment 0 0 P3 cpatient with severe systemic disease 0 0 P4 cPt w/severe systemic disease constant life threat 0 0 P5 cMoribund patient not expected to survive w/o operation 0 0 SU cProcedure performed in physician's office 0 0 UE cUsed Durable Medical Equipment 0 0