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Tag Archives: Modifiers

RVU Calculations when modifiers are added to the CPT

I am looking for a calculator (excel, application, vendor, etc) that shows that whenever a modifier is appended to a charge that affects the reimbursement, how it is calculated. For instance, 20610 is billed with 1 unit but we need to add modifier 50 to show bilateral. Modifier 50 reimburses at 1.50 of the wRVU. So, the work rvu for one unit is .79 but, the actual wrvu, due to the modifier would be 1.18. Does anyone know of any program that is available that works with billing software to help determine what the true wRVU value would be?

Medical Billing and Coding Forum – General Discussion

Need Help with Modifiers

Could someone please help me out with placement of modifiers.

Claim was submitted as below. Line 2, 4, 5 and 6 denied. Invalid modifier, included in another procedure.

Line 1 99213 25 M76.52 Patellar tendinitis left knee, M25.362 Other instability left knee, M25.361 Other instability right knee
Line 2 20611 M76.52 Patellar tendinitis left knee
Line 3 20611 50 M76.51 Patellar tendinitis Right Knee
Line 4 29530 59 M76.52 Patellar tendinitis left knee
Line 5 29530 50 59 M76.51 Patellar tendinitis Right
Line 6 J2000 M76.52 Patellar tendinitis left knee

Thank you

Medical Billing and Coding Forum – Family Practice