modifier in medical coding

 

MEDICAL CODING CLASSES IN KOCHI.

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                Medical Coding is converting a diagnosis or symptoms, procedures, and drugs into codes and Medical billing is billing insurance companies and patients for procedures and office visits. Their work is submitted to insurance companies for payment purposes, data collection, research, billing and quality improvement purposes.

                MODIFIER

            A medical coding modifier is two characters (letters or numbers) appended to a CPT^® or HCPCS Level II code. The modifier provides additional information about the medical procedure, service, or supply involved without changing the meaning of the code. 

CPT modifiers (also referred to as Level I modifiers) are used to supplement the information or adjust care descriptions to provide extra details concerning a procedure or service provided by a physician. Code modifiers help further describe a procedure code without changing its definition.

According to the CPT book, "A modifier provides the means to report or indicate that a service or procedure that has been performed and has been altered by some specific circumstance but has not changed its definition or code." That is, a modifier indicates that there were some special circumstances about the provision

EXAMPLE:  A modifier is a word, phrase, or clause that modifies—that is, gives information about—another word in the same sentence. For example, in the following sentence, the word "burger" is modified by the word "vegetarian": Example: I'm going to the Saturn Café for a vegetarian burger.

MODIFICATION CODE:

            Code modifiers are codes that supply further information about a CPT or HCPCS code, such as if the procedure was more complicated than normal or performed under unusual circumstances.

Advantages of Using Modifiers

• Avoiding claim denials by submitting clean and accurate claims.
• Submitting claims with a higher level of coding specificity and obtain the right reimbursements.

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