Modifiers and their role in Maximizing Revenue
If you ever travel to a foreign country where you don’t know the language, you will find it difficult to communicate the right message. You might think you’re asking where to get a taxi, when in fact, you’re asking something embarrassing. The point is, you’re not going to get that taxi.
Same is the case with chiropractic codes and modifiers in medical billing. They have their own language and when not used correctly, the right message is not delivered. Chiropractic modifiers are used to tell insurance companies that each chiropractic medical billing service is different from rest of the codes billed.
Mistakes while adding modifiers may result in errors that may affect your reimbursement rates negatively.
It is important to know about different chiropractic modifiers to be able to receive timely reimbursements.
This modifier is used in cases for a service that is distinct and independent from the other services provided on the same day of service. For example, EM services on the same day do not require this modifier. When another modifier is appropriate, it is not required to be used.
Modifier XS, XE, XU and XP
XS modifier is used when a service is distinct as it is being performed on a separate body part. Modifier XE is used to describe separate encounters for the same Date of Service. XU modifier is used for a service that does not overlap usual components of the main service whereas, XP modifier is used when it is performed by a different practitioner. These modifiers were developed to provide greater reporting specificity in situations where modifier 59 was previously reported.
AT modifier is used when reporting service codes 98940, 98941, and 98942 to Medicare, only when the patients are in active treatment phases of chiropractic care. It is often required for services rendered under Medicare contracts or claims containing these, can be misinterpreted as maintenance or custodial services, which are not reimbursable.
25 Modifier is used when a chiropractor performs an EM service in the same day a procedure is done. Some chiropractors add a 59 or other additional modifiers in the claim which invites unnecessary claim denials.
The knowledge of accurate modifier application is important to make the reimbursement process seamless. Chiropractors need to take care of many things which may feel overwhelming at times. Providers of outsourced chiropractic billing services help them focus on patient care and obtain reimbursements easily.
They invest in the industry’s best minds to make sure that only clean claims are submitted and are processed in a maximum time of 45 days. With the knowledge of modifier application and CPT codes at hand, denials are kept at a distance and your chiropractic practice observes considerable levels of growth.
Bikham Healthcare with its years of experience and 100% HIPAA compliance in chiropractic billing services helps chiropractors deliver quality services to their patients. Visit www.bikham.com for more information on how our chiropractic billing services can help in your practice growth.