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Summary
This is the list of Procedure Code Modifiers used for Clinical CaseNotes.
History
The stock list of modifier codes in Freemed-YiRC (V1.10 and earlier) dates back to the Ohio MACSIS HCFA-1500 electronic file format, which used a set of two-character modifier codes from F0 to F9 and T0 to T9. However, that system was replaced by the newer HIPAA 837 format, which uses a different set of codes. See the below topics for more information.
Discussion: The List of Modifier Codes (Updated 7/2009)
The list of modifiers which came with your version of Freemed-YiRC (V1.10 and below) may be obsolete. As of the switch from the old HCFA 1500 electronic file format to that of the new HIPAA 837 format (phased in around July 2003, at least in Ohio for MACSIS), the system now looks for Procedure Code Modifiers in the list in the Clinical Services DB. These modifiers are now linked to the procedure codes themselves with one exception. Hence, the Modifier drop-down field on clinical notes is virtually worthless for the new HIPAA 837 format, but please read on...
The one exception relates to the usage of the new HIPAA 837 modifier code GT, which is used when telephone contact is made and is not face-to-face. This may or may not be billable by your agency, I cannot answer that question for you, but my understanding is billing for these services can only be done under very limited circumstances. If your agency can bill for contacts made by telephone, then Freemed-YiRC looks to see if a modifier code was used that begins with a capital T. i.e., the old MACSIS HCFA-1500 T0 - T9 codes.
Therefore, you can likely reduce the list of modifier codes to just two entries:
- T0 - To indicate a telephone contact
- (blank) - To indicate a regular, face-to-face, contact.
In order for this above to work, the module setting - enable_modifier_t#_GT_codes for the MedBill module needs to be left as Disabled (if you do not have this module setting, then do not worry, as this is the default action, and as long as that module setting does not exist OR if it does exist if it is NOT set to Enabled, you are OK).
2nd Modifier Code Field (Updated 7/2009)
For all versions of Freemed-YiRC V1.10 and earlier, Freemed-YiRC does not use the 2nd modifier code, it's left blank (equivalent to 99 - Client Present in the newer HIPAA 837 format). Freemed-YiRC V1.20 will contain a code update which will make the use of this code available. The only use for this code is for when a service can be billed for a service where the client is not present. This is the UK value in the newer HIPAA 837 format. Your agency may or may not be able to bill for this type of service, it's up to you to obtain this information. If you wish to enable this functionality, only available in Freemed-YiRC V1.20 or later, then you need to enable the enable_modifier_t#_GT_codes module setting for the MedBill module. This is set to Disabled by default. This requires the use of a data field in all your Clinical CaseNote NID templates named present (that needs to be the DB data field name, what you call it on the form can vary, but typically would read Client Present?). It should be a character field, i.e., char(1), and would typically be set to a Yes/No type field. If left blank, that indicates the client was NOT present. If set to X, that indicates the client WAS present.
