Wiki 'DR' Modifier

[abarber82777]

I work for a cancer center and the providers have recently started submitting their charges with a modifier of 'DR' and it's not being rejected by EPIC, but I can't find it in my HCPS books. What is it and what is the proper use?

 

[sls314]

I work for a cancer center and the providers have recently started submitting their charges with a modifier of 'DR' and it's not being rejected by EPIC, but I can't find it in my HCPS books. What is it and what is the proper use?

EncoderPro shows this under DR for a HCPC modifier:

DR

01/01/2001

Ambulance transportation from diagnostic or therapeutic site other than P or H to residence

I work for an oncology group, and we do not use that modifier for anything. However, I work professional claims not facility.

I did also find information about Condition Code DR and Modifier CR, which are apparently disaster related. That doesn't sound like it really fits with your scenario either though.

 

[rachaelwilleford]

I work for a cancer center and the providers have recently started submitting their charges with a modifier of 'DR' and it's not being rejected by EPIC, but I can't find it in my HCPS books. What is it and what is the proper use?

I found a resource (https://www.cms.gov/files/document/se20011.pdf), and thought maybe this would apply. However not really sure of your situation, so I did include the link for the Medicare resource.

"Allows extended neoplastic disease care hospitals to exclude inpatient stays where the hospital admits or discharges patients to meet the demands of the emergency from the greater than 20-day average length of stay requirement, which allows these facilities to be excluded from the hospital inpatient prospective payment system and paid an adjusted payment for Medicare inpatient operating and capital-related costs under the reasonable cost-based payment rules."

 

[thomas7331]

I work for a cancer center and the providers have recently started submitting their charges with a modifier of 'DR' and it's not being rejected by EPIC, but I can't find it in my HCPS books. What is it and what is the proper use?

DR is not a valid HCPCS modifier (Condition code DR, referenced in the above posts, is something entirely different and wouldn't go in the modifier field.) You can find the complete HCPCS modifier list here: https://hcpcs.codes/modifiers/

When I worked on EPIC, I occasionally noticed that this system sometimes did append odd modifiers, but these don't actually go out on the claims. EPIC may be adding it as some kind of internal tracking code. You might inquire with your organization's EPIC specialists and see if they can help you with it.