Medical Billing and Coding
Explain the purpose of modifiers.
Give three examples and explain how they would be used:
1.
2.
3.
ANSWER.
Modifiers.
* Modifiers represent the medical or surgical procedures which are
performed by health care providers become changed by some
set of conditions but it not changed it's code.
* It helps the health care providers to effectively communicate with the
insurer about their payments.
* It helps to report
* If a service is provided multiple times.
* Bilateral procedures.
* Professional and technical component of a procedure.
* Mandated services.
* Discontinued procedure.
* Unrelated procedures.
Examples.
1) Modifier 47 - Anesthesia by surgeon
If anesthesia is performed by a surgeon during the surgical procedure
this modifier is added to the basic service.
2) Modifier 57 - Decision for surgery.
If during evaluation and mangement service a decision taken to perform a
surgery then this modifier added to the evaluation and management code.
3) Modifier 53 - Discontinued procedure.
If a physician discontinued a procedure for avoiding increased risk of
complications and well being of the patient then add this modifier to the
code of service.
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