I agree with Michele, if you already "feel" it's not right, it's probably NOT right. Routinely adding a modiier on your own is probably dangerous business if you are not a certified coder and not looking at the documentation you are billing. Even if you are a certified coder, the liability is the same, your putting yourself at risk by doing something routinely as you describe. It's probably UNLIKELY that every visit your appending the modifier is warranted so you really want to take a look at what your looking at in coding. Cover yourself.