Modifier Page

You can to add or edit modifiers for procedure codes.

The Modifier page contains the following panels:

Header Fields

Field	Description
Modifier	The code that identifies the additional information or change to the description of procedure in order to improve accuracy or specificity. This field cannot be changed after it is saved the first time. Format: 2 characters Examples: QK, QW, AA, AD
Short Description	The short description of the modifier for the procedure code. Format: Up to 40 characters in length. Example: Surgery, wrong body part
Long Description	The long description provided by CMS for the modifier. Example: Anesthesia services personally performed by the anesthesiologist
Characters Remaining	Counter that indicates how many characters you have available when entering text. It decreases by one for each character entered and increases when a character is deleted. Default: 320 characters
Modifier Type	The type of modifier.This field cannot be changed after it is saved the first time. Example: Pricing, Billing
Pricing Percent Change Reason	The reason that the pricing percent for this modifier is to be changed. This field cannot be changed after it is saved the first time.
Begin Date	The date that the modifier became effective. This modifier cannot be used on claims when the service date occurs before this date. Format: MM/DD/YYYY
End Date	The date that the modifier expired. This modifier cannot be used on claims when the service date occurs after this date. Format: MM/DD/YYYY Default: 12/31/9999

Field

Description

Modifier

The code that identifies the additional information or change to the description of procedure in order to improve accuracy or specificity. This field cannot be changed after it is saved the first time.

Format: 2 characters

Examples: QK, QW, AA, AD

Short Description

The short description of the modifier for the procedure code.

Format: Up to 40 characters in length.

Example: Surgery, wrong body part

Long Description

The long description provided by CMS for the modifier.

Example: Anesthesia services personally performed by the anesthesiologist

Characters Remaining

Counter that indicates how many characters you have available when entering text. It decreases by one for each character entered and increases when a character is deleted.

Default: 320 characters

Modifier Type

The type of modifier.This field cannot be changed after it is saved the first time.

Example: Pricing, Billing

Pricing Percent Change Reason

The reason that the pricing percent for this modifier is to be changed. This field cannot be changed after it is saved the first time.

Begin Date

The date that the modifier became effective. This modifier cannot be used on claims when the service date occurs before this date.

Format: MM/DD/YYYY

End Date

The date that the modifier expired. This modifier cannot be used on claims when the service date occurs after this date.

Format: MM/DD/YYYY

Default: 12/31/9999

Modifier Details Fields

Field	Description
To add information for this modifier for a particular date range, click Add Modiifer Details. To edit, in the Modifier Details table, click the appropriate row.
Show Voids	Indicator to display voided (inactive) records. Select to display both active and inactive records. Leave blank to display only active records.
Void	In the table, if the field is checked, the code span has been voided and cannot be changed. Hover over the field to display the date it was voided. When editing, indicates whether the code span is active (No) or inactive (Yes). If inactive, the code span is ignored when processing. Only code spans with beginning dates in the past can be voided. Code spans with beginning dates in the future can be deleted.
Begin Date	The date the modifier detail span is effective. Format: MM/DD/YYYY
End Date	The date the modifier detail span has been terminated. Format: MM/DD/YYYY
LOB	Unique code that identifies the line of business, a high-level payer or funding source such as Medicaid that applies to the pricing percent for this modifier.
Pricing Percent	The percentage of pricing assigned to the modifier. <<DOES THIS INDICATE HOW MUCH OF COST OF PROCEDURE WITH THIS MODIFIER THAT WILL BE REIMBURSED?? WHAT IS IT BASED ON???>>>

Field

Description

To add information for this modifier for a particular date range, click Add Modiifer Details. To edit, in the Modifier Details table, click the appropriate row.

Show Voids

Indicator to display voided (inactive) records. Select to display both active and inactive records. Leave blank to display only active records.

Void

In the table, if the field is checked, the code span has been voided and cannot be changed. Hover over the field to display the date it was voided.

When editing, indicates whether the code span is active (No) or inactive (Yes). If inactive, the code span is ignored when processing.

Only code spans with beginning dates in the past can be voided. Code spans with beginning dates in the future can be deleted.

Begin Date

The date the modifier detail span is effective.

Format: MM/DD/YYYY

End Date

The date the modifier detail span has been terminated.

Format: MM/DD/YYYY

LOB

Unique code that identifies the line of business, a high-level payer or funding source such as Medicaid that applies to the pricing percent for this modifier.

Pricing Percent

The percentage of pricing assigned to the modifier. <<DOES THIS INDICATE HOW MUCH OF COST OF PROCEDURE WITH THIS MODIFIER THAT WILL BE REIMBURSED?? WHAT IS IT BASED ON???>>>

Version as of 5/16/14.