Modifier FL?

[wiggsfamily6]

I am a CPC but am currently working for a health system doing claim denial follow up. Our coders are telling me that modifier FL is appropriate for CPT code 90471. I don't find anything indicating that modifier FL exists. Has anyone else heard of this?

 

[CodingKing]

Never heard of modifier FL either. Do they say what the modifier is supposed to stand for?

 

[mitchellde]

It is entirely possible that this is an internal use modifier that never actually posts to the claim. They should be able to articulate the meaning of this to you and under what circumstances it is to be used for .. such as for all children under the age of 15 or for Medicaid payers only. If they cannot tell you what it means in their system, then perhaps they have no real idea why they use it and the practice should be discontinued.

 

[wiggsfamily6]

Modifier FL

Our coders are telling me it is an appropriate modifier to indicate the flu vaccine and is what triggers the appropriate charge. I believe this should be an internal modifier within EPIC, that should not be going out on the claim.

I'll go back to them and ask for clarification. Thank you for your replies!

 

[mitchellde]

I am 100% certain this is an internal modifier your administrators had programmed in to the system, however it should be applicable to only certain payers such as Medicaid. This is how I have had things like this before especially with vaccines and Medicaid. It triggers the system to bill the vaccine differently for a certain payer or type of patient.