Modifiers

Have you ever been entering charges, only to see this warning pop up?

If you are entering charges and enter a modifier that is not on the Standard Modifier List, Rexpert will give you a warning popup in case you mistyped or were mistaken. But then when you click OK, the warning will disappear and the charge will save as normal, rather than making you change the modifier before saving. Why?

Rexpert has built-in features to catch typos, errors, and omissions before they ever get saved, but in the case of modifiers the situation is a little more complex. There is a Standard Modifier List, but sometimes the correct modifier for a charge is one that's not on the list. This is because while CMS keeps a list of modifiers acceptable for Medicare, other insurance companies may have their own additional modifiers or different regulations for how to use a modifier. If you take into account all the insurance companies there are and the vast opportunity for situations requiring a modifier (anesthesia, mental health, dental, etc.), it's easy to see how the modifier list could soon have thousands of entries.

The long and short of it is that the best way to ensure accuracy is not for Rexpert to bar you from entering modifiers that are not on the standard list, but to simply prompt you to reexamine your modifier to make sure that YOU know it's right.

Written by Laura Rowe