Modifiers

ZOLL Billing supports Medicare modifiersClosed Modifiers are used to report or indicate that a service or procedure has been altered by some specific circumstance but not changed in its definition or code. that identify certain facility types. These modifiers enable your system to quickly identify a pick up/drop off location type in order to determine payment. For example, Medicare will not pay providers to drop off a certain locations such as a physicians office. While Medicare does not pay for this service, many payers will so ZOLL Billing provides modifiers in addition to the Medicare list.

Note: There are three facility types that do not have an assigned modifier, Other, Pharmacy, and Dialysis Center. If the facility type has NO MODIFIER ASSIGNED then the system will not automatically enter a modifier on the Charges page. If the facility you selected is assigned to one of these facility types, you must manually add a modifier to the charges before you submit the claim or change the facility to a different facility type.

Assigning a type to a new facility

When you create a facility, you select a facility type which determines which modifier is used. You create a facility in one of two ways, on the fly during claim creation and in Admin.

Changing the type of an existing facility

If the type that was assigned to the facility does not have an assigned modifier, you may want to change the type to one that does. Here's how:

  1. On the navigation bar, click Facilities.

  2. Click the All facilities tab and scroll through until you find the facility name.

  3. Click the facility name.

  4. On the right-side of the page, click Edit.

  5. Click the Designation field and select a new type from the list.

  6. Click Save changes.

Modifier list

Note: Not all designations have the modifier. Currently, Dialysis Center, Other, and Pharmacy do not have one. Read more about the new Medicare ET3 program.

The following is a list of modifiers available in ZOLL Billing:

  • Assisted Living Facility in ZOB - E

  • Community Mental Health Center - C

  • Diagnostic/Therapeutic Site - D

  • Dialysis Center = NULL - NO MODIFIER ASSIGNED

  • Dialysis Free Standing - J

  • Dialysis Hospital Based - G

  • Federally Qualified Health Center - F

  • Hospital - H

  • Hospital-Based Dialysis Facility - G

  • Intermediate Stop at Physicians Office En Route to the Hospital - X

  • Landing Zone - I

  • Mental Health Facility - D

  • Nursing Home - E

  • Non-Hospital Based Dialysis Facility - J

  • Other - NULL - NO MODIFIER ASSIGNED

  • Pharmacy - NULL - NO MODIFIER ASSIGNED

  • Physician Office - O

  • Physician's Office/Clinic - P

  • Residence - R

  • Residential - E

  • Scene of Accident - S

  • Site of Transfer (e.g. airport or helipad) - I

  • Skilled Nursing Facility - N

  • Urgent Care - U

The modifiers display on the Claim page under the Incident Details tab.