Modifiers Matter: A Modifier Overview for All Physician Practices
1. Modifiers Matter: A Modifier Overview for
Presenter
Leesa A. Israel
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Learn Some Common Pitfalls for Each Modifier and How to
Overcome or Avoid Them
2. Disclaimer
I am a writer, a coder, and an auditor, not an attorney.
Although the information has been carefully researched
and checked for accuracy and completeness, the
presenter and Audioeducator.com carry no
responsibility or liability with regards to errors,
omissions, misuse, or misinterpretation.
CPT®
is registered trademark of the American Medical
Association.
3. Agenda:
Uncover why it is critical to understand how to use modifiers.
Get to know what modifiers actually do and review the different types of
modifiers.
Look at different individual CPT®
modifiers that you will use in your practices:
Modifier 24
Modifier 25
Modifier 57
Modifier 59
Modifier 22
Modifiers 50/LT/RT
Modifier 51
Modifier 52
Highlight the HCPCS modifiers you’ll use, such as QW and Q5/Q6.
Go through specialty-specific examples for each modifier.
Take a look at some pitfalls for each modifier and how to overcome or avoid
them.
Modifier 53
Modifier 58
Modifier 78
Modifier 79
Modifiers 26/TC
Modifier 54/55/56
Modifier 62
Modifiers 80/81/82
4. Modifiers Can Make or
Break Your Claim
Assigning the proper procedure code for
services your physician provides is often
only half the battle. If you’re not
appending the proper modifier — or if
you’re assigning the wrong modifier —
you risk miscoding and denials.
5. Modifiers allow you to:
Indicate that a service or procedure
was altered in some way, but the
main code descriptor has not
changed.
6. Use modifiers to …
Provide the payer with additional
information
Help explain clinical situations
Break bundles
Capture deserved extra payment
7. If you don’t know how to use
modifiers, you could be:
Fraudulently billing
Violating bundling rules
Wasting time on unnecessary
appeals
Losing deserved reimbursement
Raising audit red flags
8. To see the complete presentation
check the below link:
http://www.audioeducator.com/coding-updates/modifier-
matter-10-14-2014.html