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Billing modifiers

Developers
#1

THEMIS WG1 just had a great discussion about modifiers.

Modifiers are assigned to procedural codes (e.g., CPT).
Example of modifiers are here:

Multiple modifiers (up to 16) can be assigned to a procedure.

To complement the discussion, at the this below (in Czech) are modifiers from the Czech republic.

https://szv.mzcr.cz/Vykon/Export

They are called “signaling codes” (translated as ‘SIGNÁLNÍ VÝKON’)
Examples below (in Czech)

image.png1242×600 47.8 KB

Some US modifiers can be mapped to an existing SNOMED CT code. It seems like some modifiers can be common across multiple OECD countries.

#2

@Vojtech_Huser:

What’s the question?

#3

just like position on finger - a dental code can have a position on a certain tooth or part of the tooth. (another example here: https://confluence.ihtsdotools.org/questions/52181655/example-coded-dental-record )

There is no specific question.

But if you insist -
1.
How can we best capture useful clinical detail from billing modifiers (considering international data)?

What are the common modifiers that are used in more than 1 country? (if there are any)

Should the modifiers be managed by input terminology (e.g., SNOMED CT, less maintenance) or by OMOP Vocab team (athena team) (more maintenance for us)?

This is also related to an effort to make international procedures be like international diagnoses.

#4

The issue was addressed here. Please take a look.

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