Why doesn't QuickCheck add all modifiers, like Modifier 57, for example?

QuickCheck already shows you were modifiers 24, 25, 51, 59, 76, and 91 should be added on up to 10 CPT codes.

As far as other modifiers in QuickCheck, it is not possible to determine based on logic or without additional inputs from the user if certain modifiers are needed. For these types of modifiers (digit modifiers, ABN modifiers, bilateral procedures, pathology modifiers, staged procedures, etc.), the biller will need to make the determination on a case-by-case basis whether additional modifiers are needed for the claim.

For example, modifier 57 is tricky as its usage varies so much from carrier to carrier. Most carriers do not prefer it. CPT says it can be added to the E/M visit when billed with any surgical service (i.e. 0,10, or 90 postop days) when that E/M visit resulted in the decision for surgery. Medicare says it’s only for major surgical services (i.e. those with 90 postop days). DermCoder doesn’t know which carrier you are billing to and what the carrier’s preference is (i.e., any surgical service or just major services).

Last Modified 2/7/2013 10:33:42 AM