CPT code modifiers provide additional details regarding various services. There are three ways to ensure that you are using modifiers appropriately:
1.Use modifiers to improve reimbursement and avoid denials. Software technology is available that will prompt physicians to select all appropriate modifiers at the time of service.
2. Know your payers' policies regarding the use of modifiers. Rules may differ among payers.
For Example:- If the modifier is likely to reduce the amount of payment, leave the amount as is and let the payer reduce it when the payer receives the claim. If the modifier is likely to increase the payment, increase the amount on the claim before you file it; do not expect the payer to do it for you.
For example, you should assign modifier "-24" to any CPT code to designate any "unrelated evaluation and management service" that you provide during a postoperative visit.
3. If you do not attach the modifier, you will not be paid for that encounter.
Technology is available that will remind you and allow you to assign appropriate modifiers at the time of each encounter and teach you which modifier to use as it displays the options in front of you.
If u need more clear idea please send me a link where i can post my document on CPt Codes and Modifiers.
Last Wiki Answer Submitted: March 14, 2011 1:31 am by Healthcare12340 pts.
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