Modifier Codes

(1) Modifiers shall be added to the procedure code when the service or procedure has been altered from the basic procedure described by the descriptor. (2) Tennessee state-specific modifiers listed in 0800-02-18 may be added to the procedure code when criteria set forth in chapter 18 have been met. (3) The use of modifiers does not imply or guarantee that a provider will receive reimbursement as billed. Reimbursement for modified services or procedures shall be based on documentation of reasonableness and necessity and shall be determined on a case-by-case basis. For more information on modifiers, see Chapter 0800-02-18.