What is the purpose of modifiers in CPT coding?

The purpose of modifiers in CPT coding is to provide additional information about the service or procedure performed. Modifiers are two-digit codes attached to the primary procedure code that clarify circumstances affecting the procedure, such as whether it was a bilateral procedure, if it was a repeated procedure on the same day, or if special circumstances were present during the service. This additional context is essential for accurate reporting and reimbursement, as it allows payers to understand the nuances of the service provided beyond the basic description of the procedure.

Using modifiers properly ensures that the coding reflects the complexity or details of the care given, thereby supporting appropriate payment and avoiding potential billing issues. It aids healthcare providers in communicating with insurers and enhances the accuracy of patient medical records.