Each charge line can have up to four modifiers. After the charge is accepted, the first modifier field will fill with the default modifier for the procedure. To add other modifiers just click in the field and select from the pop-up list. The list of current modifiers is stored in the PickList User database. A sample of common modifiers is below.
If you perform procedures that have a defined post-operative period, this date is stored in the Billing Information section of the patient's record in PostOp Ends (see below). If you try to create an invoice during the post operative period you will be prompted to use the correct modifier (usually 24 or 79).
If you do more than one procedure on the same patient the same day, insurances pay 100% for the first procedure, 50% for the second and 25% for each additional. PracticeMaker® will calculate your expected reimbursement IF you use modifier 51 for the second and additional procedures. In the first example below, note that the second procedure does not not have the 51 modifier. There is no adjustment to the Approved amount.
However, if the example below, the second procedure has the 51 modifier associated with it and PracticeMaker® decreased the approved amount by 50%.
Warning: Be very, very mindful when you manually enter a modifier rather than selecting it from the pop-up lists. If the modifier that you enter by hand is not correct, and you submit claims electronically, your entire electronic claims file will be rejected.
Updated 8/27/2004