The No Surprises Act: Protecting Patients and Promoting Transparency
Legislation, Medical Billing Information, Medical OfficeThe No Surprises Act is a significant piece of federal legislation that aims to address the issue...
Modifiers in medical coding are essentially phrases added onto the end of the sentence formed by the normal code. Where coding provides the basis for the language that unites healthcare organizations and payers, modifiers provide an extension to that language as rules and regulations with Medicare and payers are added or changed.
Some medical practices incorrectly believe that modifiers in medical coding are unnecessary, but they are an important part of avoiding abuse, non-compliance, and fraud. No medical practice wants to face huge HIPAA fines. But it’s also good to note that modifiers in medical coding often cause more mistakes; in fact, it’s one of the biggest causes of billing error overall.
Most modifiers in medical coding are designed to represent the item or service given. However, they all fall into one of two levels (one for each level of HCPCS codes): Level I are updated annually by the AMA (American Medical Association). Level II are updated instead by CMS. Both levels are two-digit modifiers.
If you are added modifiers in medical coding, here are a few facts to remember:
Inappropriate code/modifier combinations will be denied as unable to be processed and required that the claim be resubmitted. Avoid this extra work by outsourcing the coding and billing needs of your medical practice. Billing Advantage experts take the responsibility of these tasks off of your shoulders so that your clinic can focus on practicing medicine. Find out if you quality for our affordable standard services.
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