What is the purpose of a modifier in medical billing?

The purpose of a modifier in medical billing is to provide additional information about a procedure. Modifiers are two-digit codes that give more context to the services rendered, such as indicating that a procedure was altered in some way without changing its definition or code. This additional detail is crucial for ensuring that claims are processed accurately and that providers are appropriately reimbursed for the nuances of patient care.

For instance, a modifier might be used to indicate that a procedure was performed on a specific part of the body or to show that it was bilateral. This level of detail helps insurance companies understand the specific circumstances of the procedure, which can affect how the claim is adjudicated and how much is reimbursed.