What is the purpose of modifier codes in billing?

The purpose of modifier codes in billing is to provide additional information about a procedure or service. Modifiers are two-digit codes added to CPT (Current Procedural Terminology) codes that help clarify the circumstances under which a service was performed. They can indicate various situations, such as whether a procedure was performed bilaterally, if multiple procedures were carried out, or if a service was altered in some way.

Using modifiers is crucial for ensuring accurate billing and compliance with health insurance requirements. They help insurance payers understand the context of the service provided, which can influence coverage decisions and payment. Accurate use of modifiers can also help prevent claim denials and ensure that services rendered are adequately compensated.