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HCPCS Modifier Q4

Service for ordering/referring physician qualifies as a service exemption

Modifiers

Q0-QZ Q Modifiers

Q0 Invest clinical research

Q1 Routine clinical research

Q2 Demo procedure, service

Q3 Live donor surgery/services

Q4 Svc exempt - ordrg/rfrng md

Q5 Recip bill arr subs md or pt

Q6 Fee/time comp subst md or pt

Q7 One class a finding

Q8 Two class b findings

Q9 1 class b & 2 class c fndngs

QA Avg sta day/night o2 < 1 lpm

QB Avg day/nite o2 > 4 lpm/port

QC Single channel monitoring

QD Rcrdg/strg in sld st memory

QE Stationary o2 @ rest <1 lpm

QF Station o2 @ rest >4lpm/port

QG Station o2 @ rest > 4 lpm

QH Oxygen cnsrvg dvc w del sys

QJ Patient in state/locl custod

QK Med dir 2-4 cncrnt anes proc

QL Patient died after amb call

QM Ambulance arr by provider

QN Ambulance furn by provider

QP Individually ordered lab tst

QR Avg sta day/night o2 > 4 lpm

QS Monitored anesthesia care

QT Rcrdg/strg tape analog recdr

QW Clia waived test

QX Crna svc w/ md med direction

QY Medically directed crna

QZ Crna svc w/o med dir by md

Date	Action	Notes
1994-01-01	Added	Code added 1/1/1994