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How to Add Modifiers to an Invoice

Modifiers are codes added to invoices to adjust procedure prices based on clinical factors like emergencies or assisting physicians. Omitting a needed modifier can cause underpayment, while incorrect use or placement may lead to claim rejections. For surgical invoices needing price adjustments, modifiers are listed as separate line items after the related procedures.

How to add a modifier line

  1. Navigate to the "Accounts" tab 
  2. Search for the required patient
  3. Select the "Capture invoice" option
  4. Complete the invoice header (treating provider, date of service, diagnosis code)
  5.  Add the procedure line or lines for the visit. Modifiers are always added after the procedure lines they relate to.
Capture invoice screen showing the invoice header and procedure line fields

How too Add a modifier line 

  1. Navigate to Invoice capture screen and complete the required. 
  2. Click on "Add a line" a new blank line appears at the bottom of the invoice lines.
Invoice with a procedure line added, showing the Add a line button below it

Set the line type to 'Modifier'

  1. On a new line row select the "Line type" dropdown.
  2. Select 'Modifier' from the dropdown and search the required code.
  3. When the modifier modal opens and shows an 'Apply to' checkbox list, that list is populated from the lines already above the modifier on the invoice. This is why procedure lines must be added before the modifier lines that depend on them.
  4. Each modifier must be its own line. If you need to add the same modifier twice (for example, two separate 0011 lines for an emergency procedure involving both a surgeon and an assisting doctor), click 'Add a line' again and repeat the process — do not increase the quantity of an existing modifier line.

How to enter the modifier code in the correct field

  1. Type the modifier code (e.g. 0011). The autocomplete list will appear. Click the matching result to select it.
  2. For modifiers that require additional information (0011, 0008, 0009, 0018), a modal dialog will open automatically asking you to supply the required details before the line is added.
Modifier details modal for 0011 showing Clinical RCF, Start time, and End time fields

 

Complete the modal fields and click 'Save'

  1. Each modifier has different fields, If you click 'Cancel', the modifier line is removed and you return to the invoice.
  2. the modal closes and the modifier line appears on the invoice with the correct calculated amount and a description showing the details you entered.
  3. To edit a modifier after saving Click the expand icon on the modifier line row to reopen the modifier details modal and make changes. The system will recalculate the price.

Coding order — what a surgical claim looks like

The order in which you add lines to the invoice matters. The 'Apply to' checkbox list inside each modifier modal only shows lines that already exist above the modifier you are adding. This means you must add procedure lines before the modifiers that depend on them.

The standard sequence for a surgical claim is:

  1. Procedure line(s) — add all surgical procedures first.
  2. Modifier 0018 (if applicable) — BMI modifier comes next, directly after the procedure(s) it applies to, so its value is included when 0009 is calculated.
  3. Modifier 0011 (if applicable) — emergency time modifier for the surgeon.
  4. Modifier 0009 or 0008 (if applicable) — assistant fee modifier. This comes last so that when you open the 'Apply to' list, the procedure and any applicable modifier lines (e.g. 0018) are already there to select.
  5. A second 0011 (if applicable) — for the assisting doctor's emergency time, added as a separate line.

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