Billing with Modifier 50 in Athena for Xrays and Injections (Units?)


Charleston, West Virginia
Best answers
Hello. :) I apologize in advance for bombarding everyone with questions, but as we have transitioned to Athena, we are stumbling onto some issues. Here is our current conundrum:

We need to bill our injection codes (such as 20610) with modifier 50, and 1 unit with double the fee for most insurances, with exceptions like BCBS, which is billed out as modifier 50, 2 units, and split a single fee. For x-rays, we typically need to bill a 50 in the modifier and a 2 in the units, with the single fee, with the exception of one insurance.

From what I am seeing, we can't manually go in and alter the fee on the claim... and if we make the 50 modifier fee affecting, then if we put 2 in the units, then it will essentially quadruple the fees. Is there an easy work-around to this or am I misunderstanding completely?

Thank you! I appreciate your patience!