Home Forums Discussions Problems Billing Modifiers

Is anyone still having the problem of entering non-standard modifiers such as GA or GY for medicare or anything that does not appear to be in the drop down list.

I think I've found bug which provides a work around for it... This appears to be a problem since 8/2006 and hasn't been fixed yet... unless there is a new beta version that fixes this.

Hmm.. nope, that's definitely a bug. The pull-down list is pre-loaded. We had to add SL for the shots for kids program.

If we put a list of 'em together I'll send Jon a patch.

V.

Vinny,

May I suggest that instead of hard coding it into the source code, load it from a database table so it can be modified?

Thx

Loading it from the database would be SLOOOOOOWW.. BUT, If the ones manually added were saved in the windows Registry (like your common meds are) That wouldn't be TOO bad. Seems all of the added modifiers are alpha while the standard ones are numeric?

If so, I'll either discuss with Jon or try to bang something out and send it to him.

V.

The easiest solution is to make it both a drop down pick list and option to enter it by direct typing. Solves future issues with "this code is not included" or "insurance added this code for our specific region". Where you store the pick list won't matter with this solution. By the way, I found a *bug* to enter it anyways but it does not get generated (put into the CMS-1500). Just a simple copy a text like "GA" and paste and it will get it past the inability to enter it directly... but as I said, it won't be generated into the CMS-1500 bill.

Don't understand why loading it from the database would be "SLOOOOOOWW". Load at time of App launch so it persists during the life of the App since it's not something you modify more than once in a blue moon. It should be loaded from a local DB file on the computer so there is no need to load it across the network.

We have to refile EVERY lab with Oklahoma Medicaid because of modifiers....most especially is the strep screen which requires QW.

I guess I don't understand the windows registry.

How do I get to it?

I suppose each user on a computer (and each computer on the network) will have a window registry entry so that changing a medication, code or allergy by window registry method will require tapping into each computer and each user on the computer. Am I correct with this assumption?

Roy,

The windows registry is basically a database which stores settings for the operating system. It controls hardware and the OS software. When Windows is installed everything that is Windows pretty much is controlled by what's in the registry. Your desktop settings, the color of your wallpaper, everything. When you install a program if you watch closely, you will generally see "updating Windows registry" as the program installs many, many keys into the registry so that Windows can interact with it. This is why when you uninstall a program, you don't just go to Program Files and the application and delete it. The Add/Remove programs or native uninstaller deletes the programs and the registry keys. The problem is with multiple installs and uninstalls the registry gets "cluttered" with unnecessary files such as .dll files, etc. Eventually, your PC slows down or things start acting weird and you spend the day reformmatting. There are many "registry cleaners" out there, some free, but I find they only put off the inevitable.

You can "tweak" the registry and make changes to how you OS runs. Again, there are tons of programs which interface with the registry and make these changes for you, the most famous probably being Tweak UI which allows you to get rid of the arrows on shortcuts, etc. All of these tweaks could be done manually.

To get to the Windows Registry, simply click on Run on your Start Menu then type in "regedit" without the quotes. Microsoft recommends you back up the registry by clicking on File -> Export. You can also back up folders, keys, etc. Simply clicking on the Rubik's cube-appearing backup on your desktop will restore the backup. Probably the best way to understand the registry is to make a change that you are confident won't harm the computer. One of my favorites which I do after all installs is on "menushowdelay."

Open the registry, go to HKEY_CURRENT_USER, Control Panel, then Desktop. In the windows to the right, you will see the String Value, "Menushowdelay." Double click it or right click it and choose modify and it will open in its own window. The default value data will always be 400. I generally change it to 50, but you can change it to something faster like 10. After entering the new number close it, and your change will take effect. Don't worry, this change is very safe, and you can do it without backing up the registry. Now, when you click on All Programs from the Start Button, it will roar to life much more quickly; 8 times as fast to be exact if you change it to 50, although you don't always get that full effect. If you find it too fast, change it to a higher number. At 50, you will find that hovering over the different shortcuts on the menu will allow the sub menus to pop out to the right almost instantly.

You could also get to "menushowdelay" or any other key or string, but using the Find or Find next.

You are correct in that changing the Windows Registry will only affect that computer you are on.

I would also highly recommend not changing the registry on your server unless you absolutely need to and then not before backing up the registry and possibly doing a full backup of your system. Screwing up a workstation is one thing, breaking the server is another thing altogether.

Finally, Googling Windows Registry is helpful. Hope this helps.

Registry edits are really not for the novice and I wouldn't recommended unless they are comfortable with it... which is why I suggested storage (of the billing modifiers) on the database instead of registry.

Hey guys,
Now I'm not nearly as good as the rest of you at all this techno stuff, but as an average everyday user, why can't the modifier drop down, be set up like most of the other drop downs? That we can enter free text there and now it becomes part of our own practice's forever like data? Much like as we enter new towns, states, and insurance carriers in the demographic drop downs. This way Jon doesn't have to design and enter lots of stuff for each and every state and program, yet we can enter the ones that we in particular need for our own uses. So can AC populate the basics that we all use like 25's and 52's and still let us add them as we see fit via the drop down itself? Makes sense to me, but I'm not as good with the nuts and bolts side of all of this. But I think this would be the best solution for everyone, both AC and the users if it could be made to work fairly easily.

Vinny,
We need EP under modifiesrs and 99 for POS for GA MCD Healthchecks. Please Add.

Hi Dr P

I am Dr. Jay, and I am new to billing. I have heard about these modifiers. Did anyone ever explain this to you? I don't know if different insurances need different modifiers. Tricare? Amerigroup? Wellcare? I have requested a Medicaid billing manual but have not got it yet.
J.

Hi Dr. Jay,
The Modifiers are in the manual but who has the time to read it. I found out about different modifiers in different ways and it seems like it is a secret but in fact it is in their manual. Easily accressible on the website actually. If you are dealing with Georgia Medicaid, I have no problem sharing any modifiers you may need. It is only with the Health Checks. They also announce changes in their posts on the website. An excellent billing specialist keeps up with these things but that is hard to find.
In Georgia, we need to use EP on Health Checks and N, NU for Referral Codes in special locations and POS of 99 instead of 11 for the vaccines. Idiotic things that only Mcd knows why it is like that. I assume it is their way of tracking things. Are you having trouble with any particular codes? Are you in Georgia?
By the way, Amerigroup plays a different game, they do not use the POS 99.
Again, everything for Mcd in the state of Georgia is on their website and easily accessible just not easily found, lol.