USING MODIFIERS

When you are adding modifiers to the CPT codes there are 3 ways of doing this. The way you chose will depend on the needs of your office.

1. Modifier is needed for Everyone

If the modifier is needed in every circumstance, then you will want to add the modifier at the Services level. From Open File Folder, click on Services Master Entry. Go to the Icon Show List of Records. Arrow to the service that needs the CPT Code Modifier and double click on the service to bring up the Service Entry/Edit screen. Add the Modifier here. Repeat until you are done.

NOTE: When you add the modifier here, it will take effect for this service added AFTER this has been done. Any services added prior will need to be handled in the individual patient ledgers.

2. Modifier Is Needed for One or Two Carriers Only

If the modifier is needed for only a few carriers, then this will be added at the Carrier Policy setting. From Open File Folder click on Carrier Master Entry. Use the Icon Show List of Records to find the Carrier that needs to have this modifier and go to Policy. On the first policy in the list go to the service or services that need to have this modifier and add it here. Repeat for any other policies listed for this carrier.

NOTE: When you add the modifier here, it will take effect for this service added AFTER this has been done. Any services added prior will need to be handled in the individual patient ledgers.

3. Modifier is Changeable or Only Needed Occasionally

If the modifier will change based on a specific time period or situation (i.e. Medicare in some areas requires a different modifier letter if the area adjusted is Cervical, Thoracic or Lumbar and another letter to show Acute, Chronic, etc.) If this is the situation that we need to handle, this will be done in the main loop or Services/Payments area of TPS. When you have picked the services for the you will see the services provided on this visit. If a service listed here needs a modifier, add it then click on done (assuming all discounts, payments and other actions done from this screen have been completed).

***** Adding a Modifier to Services ALREADY Delivered

If you have services for which you are billing that require a modifier and it was not added in one of the above methods, you may still correct this entry.

Open the patient’s ledger. Find the service line that needs to include a modifier when it is billed. Arrow over (or use the slide bar at the bottom of the services window going right) until you see the CPT Code column. You may add the modifier to this entry. Tab out of the field when you are done. You are ready to bill (or reprint the bill) for this patient.