Balance Systemâ„¢ SD

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Impairment Code Modifiers

Impairment Modifier Code
Impairment Percent
CH 0% Impaired
CI Between 1 - 19% Impaired
CJ Between 20 - 39% Impaired
CK Between 40 - 59% Impaired
CL Between 60 - 79% Impaired
CM Between 80 - 99% Impaired
CN 100% Impaired


Therapists should always use their clinical judgment in the assignment of the appropriate modifier. Therapists should document in the medical record how they made the modifier selection so that the same process can be followed at succeeding assessment intervals. If possible, a therapist may use the modifier that reflects the score from the functional assessment tool or other performance measurement instrument used (if any).