How do I List More Than One Modifier on an HCFA Claim?
Instructions
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Enter the Current Procedural Terminology, or CPT, code on line 24D of the HCFA 1500 form. Also, supply procedures for Medicare that fall under the Healthcare Common Procedure Coding System, or HCPCS, on line 24D.
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2
Place the first modifier, or the pricing modifier, in the following box. This is the small box beside the first line after the procedure code.
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3
Enter additional modifiers, referred to as informational modifiers, in the larger box beside the small box on line 24D. Separate the additional modifiers with a single space.
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