CPT modifier
Modifier 63: Procedure on an infant under 4 kg
Modifier 63 is a CPT modifier. In plain terms: The procedure was done on a neonate or infant weighing less than 4 kilograms, which adds difficulty.
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- Modifier
- 63
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- The procedure was done on a neonate or infant weighing less than 4 kilograms, which adds difficulty.
- How it is used
- Applies only to codes the CPT book allows it with.
- 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.
Related modifiers
Related pages
Questions
What does modifier 63 mean?
Modifier 63 is a CPT modifier. In plain terms: The procedure was done on a neonate or infant weighing less than 4 kilograms, which adds difficulty.
Is modifier 63 a CPT or a HCPCS modifier?
63 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 63 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 63 used?
Applies only to codes the CPT book allows it with.
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.