Wiki When to add modifiers

[Wanda Hayes]

I don't know when as a coder I am stepping out of bounds. Can I add modofiers without dr permission or knowledge? If superbill says fracture and cast application, can I bill for casting supplies or do I need to get it documented? I am newbie in the certified coding world and want to do it right.

 

[cgreenhoe]

C. Greenhoe CPC

My understanding is that only E/M codes need to be selected by the physician themselves. If a physician performs a service that needs a modifier, it is the coders responsibility to append the modifier per CPT guidelines to allow for a clean claim process. Good luck with your new endeavor.

 

[mitchellde]

As long as you are coding from the physicians documentation you may append any code or modifier to the claim. Which ones to use are guided always by the documentation.

 

[Wanda Hayes]

Thanks so much. I was feeling like a fish out of water but now I can get back in

 

[abbycat333]

Wanda you mentioned casting supplies. That has to be documented in the patient chart because there are several types of casting materials, so you need to know what it was. You shouldn't take a guess as to how much to bill, and should ask if uncertain. Technicians who do this all the time document in their own records how much of the supplies they used, so the office manager can figure out if there is a way to save.