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Official Description

Procedure Performed on Infants less than 4 kg:

Procedures performed on neonates and infants up to a present body weight of 4 kg may involve significantly increased complexity and physician or other qualified health care professional work commonly associated with these patients. This circumstance may be reported by adding modifier 63 to the procedure number.

Note: Unless otherwise designated, this modifier may only be appended to procedures/services listed in the 20100-69990 code series and 92920, 92928, 92953, 92960, 92986, 92987, 92990, 92997, 92998, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93452, 93505, 93563, 93564, 93568, 93569, 93573, 93574, 93575, 93580, 93581, 93582, 93590, 93591, 93592, 93593, 93594, 93595, 93596, 93597, 93598, 93615, 93616 from the Medicine/Cardiovascular section. Modifier 63 should not be appended to any CPT codes listed in the Evaluation and Management Services, Anesthesia, Radiology, Pathology and Laboratory, or Medicine sections (other than those identified above from the Medicine/Cardiovascular section).

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Short Descr Procedure Performed on Infants less than 4 kg
Medium Descr Procedure Performed on Infants less than 4 kg
Date
Action
Notes
2022-01-01 Changed Exception code list updated.
2020-01-01 Changed Description changed.
2013-01-01 Changed Changed Code for 2013
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