CPT modifier
Modifier 52: Reduced services
Modifier 52 is a CPT modifier. In plain terms: The service was partly reduced or cut short at the physician's choice, and the full code no longer fits.
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- Modifier
- 52
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- The service was partly reduced or cut short at the physician's choice, and the full code no longer fits.
- How it is used
- No anesthesia is involved. For a procedure stopped because of risk to the patient, see 53.
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
The CPT descriptor is AMA copyright and is not shown here. The description above is written by Rivvi. Read the CMS guidance linked above for Medicare's rules.
Reduced or stopped services
Related modifiers
- 53Discontinued procedure
- 73Discontinued before anesthesia (hospital outpatient or ASC)
- 74Discontinued after anesthesia (hospital outpatient or ASC)
- PTColorectal cancer screening test; converted to diagnostic test or other procedure
- 51Multiple procedures
- 54Surgical care only
- 50Bilateral procedure
- 55Postoperative management only
Related pages
Questions
What does modifier 52 mean?
Modifier 52 is a CPT modifier. In plain terms: The service was partly reduced or cut short at the physician's choice, and the full code no longer fits.
Is modifier 52 a CPT or a HCPCS modifier?
52 is a CPT (Level I) modifier. The AMA maintains CPT modifiers. Two-character codes with a letter, such as GT or XU, are HCPCS Level II modifiers from CMS.
Where does modifier 52 go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
When is modifier 52 used?
No anesthesia is involved. For a procedure stopped because of risk to the patient, see 53.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.