decisionhealth Newsletters, Part B News - 2021 Issue 10 (October)
Providers are using modifier 78 less, and getting fewer denials
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Article Overview
This piece examines recent trends in modifier usage and denial rates for a small set of commonly billed procedures, with a focus on how patterns changed over time. It is intended for coding and revenue cycle professionals who want a quick view of modifier-related claim performance, the types of procedures most frequently associated with the modifier, and broader denial-rate context.
Why This Topic Matters
Understanding how modifier-related claims are trending can help coding and billing teams monitor denial risk and compare their own reporting patterns with national experience. The article is useful for assessing whether particular procedure categories are being denied more or less often and for identifying areas that may warrant closer review.
What You Will Learn
- How modifier usage changed between two reporting periods
- Which procedures were most frequently associated with the modifier
- How denial rates varied across selected procedures and modifiers
- How an alternative modifier compared in overall utilization and denials
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Billing specialists
- Practice managers
Codes Discussed
Modifiers Discussed
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