Physical Status Modifiers Tab

Overview

The Concurrency Scheme: New and Concurrency Scheme: [name] pages are comprised of three tabs:

The Physical Status Modifiers tab allows you to record a custom modifier for each physical status modifier to appear on the claim for payers who require different modifiers than the standard unit values, for example, MediCal. The modifiers assigned to each physical status replace the physical status modifiers designated in the fee schedule when the claim is generated for that payer. The fees are calculated based on the billing units of the physical status modifier. The custom modifier only appears on the claim in place of the billing unit.

How to Get Here?

To open the Physical Status Modifiers tab for new scheme:

From the Home Page:	From the Menus:	Via Shortcut Keys:
Click Concurrency Schemes from the Admin list Click Create Click the Physical Status Modifiers tab	Open the Admin menu and select Concurrency Schemes Click Create Click the Physical Status Modifiers tab	From the Concurrency Schemes page, press [Alt] + [C] Click the Physical Status Modifiers tab

To open the Excluded Procedure Codes tab for existing scheme:

From the Home Page:	From the Menus:	Via Shortcut Keys:
Click Concurrency Schemes from the Admin list Select the concurrency scheme to be modified Click Update* Alternate Navigation: Double-click the concurrency scheme from the list Click the Physical Status Modifiers* tab	Open the Admin menu and select Concurrency Schemes Select the concurrency scheme to be modified Click Update* Alternate Navigation: Double-click the concurrency scheme from the list Click the Physical Status Modifiers* tab	From the Concurrency Schemes page, press [Alt] + [U] Click the Physical Status Modifiers tab

Field Definitions

Field	Type	Required	Description
Physical Status Modifiers	Two-Character Modifier Code	No	A custom modifier can be assigned to each physical status modifier (P1 through P5) by provider type. This modifier is shown on an anesthesia procedure on the claim to indicate the complexity of the procedure with regards to the physical status of the patient. The billing unit values assigned at the fee schedule are used to calculate anesthesia fees. By default, these values are set to the value of its respective physical status modifier, for example, P1 = P1, P2 = P2, P3 = P3, P4 = P4, and P5 = P5.
Send Physical Status Modifiers when Units are Zero	Checkbox	No	If checked, claims will include physical status modifiers when their associated unit value is zero. By default, zero values are excluded on claims.

Physical Status Modifiers

Modifier	Description
P1	The modifier that indicates a normal healthy patient. By default, the modifier is P1.
P2	The modifier that indicates a patient with mild systemic disease. By default, the modifier is P2.
P3	The modifier that indicates a patient with severe systemic disease. By default, the modifier is P3.
P4	The modifier that indicates a patient with severe systemic disease that is a constant threat to life. By default, the modifier is P4.
P5	The modifier that indicates a moribund patient who is not expected to survive without the operation. By default, the modifier is P5.

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Overview

Field Definitions

Field

Type

Required

Description

Physical Status Modifiers

Modifier

Description

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