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HCPCS Modifier AO

Official Description

Alternate payment method declined by provider of service

Short Descr	Prov declined alt pmt method
Medium Descr	Prov declined alt pmt method
Coverage	Carrier Priced
Added Date	10/1/2013

Modifiers

A1-AZ A Modifiers

A1 Dressing for one wound

A2 Dressing for two wounds

A3 Dressing for three wounds

A4 Dressing for four wounds

A5 Dressing for five wounds

A6 Dressing for six wounds

A7 Dressing for seven wounds

A8 Dressing for eight wounds

A9 Dressing for 9 or more wound

AA Anesthesia perf by anesgst

AB Aud svs w/o order evry 12mo

AD Md supervision, >4 anes proc

AE Registered dietician

AF Specialty physician

AG Primary physician

AH Clinical psychologist

AI Principal physician of rec

AJ Clinical social worker

AK Non participating physician

AM Physician, team member svc

AO Prov declined alt pmt method

AP No dtmn of refractive state

AQ Physician service hpsa area

AR Physician scarcity area

AS Assistant at surgery service

AT Acute treatment

AU Uro, ostomy or trach item

AV Item w prosthetic/orthotic

AW Item w a surgical dressing

AX Item w dialysis services

AY Item/service not for esrd tx

AZ Physician serv in dent hpsa

Date	Action	Notes
2013-10-01	Added	Added

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HCPCS Modifier AO

Official Description

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