STAT MODIFIER?

[PippiT]

Hi! United Healthcare denied xrays for a patient as not provided by a network provider. I called to inquire and radiology must go to an outside facility unless we get prior authorization. Further instruction was that if the procedure had a dx that qualified for a stat modifier, we could rebill it.

It is a fracture and she confirmed that it would qualify. This is a first for me and google is not helping, where can I find stat modifiers and are they called something else? Any help and guidance is greatly appreciated! 

[Michele]

The only thing I can find is modifier ET is for emergency services, and modifier ST is for trauma.  There is not actually any "stat" modifier, but I'm thinking that maybe they are looking to see if it was an emergency that required an xray "stat" making the prior auth not required?

[PippiT]

The only thing I can find is modifier ET is for emergency services, and modifier ST is for trauma.  There is not actually any "stat" modifier, but I'm thinking that maybe they are looking to see if it was an emergency that required an xray "stat" making the prior auth not required?

Thanks Michele! I was googling like crazy last night because this was driving me crazy and putting in different ways of asking what I was looking for and both of those mods came up. I  will try the ET.

[PippiT]

Thank you so much for your help Michele! It took a minute to have the ET modifier added to our modifier library. I resubmitted the claim last week and we received the paid EOB today. You guys have been a great resource over the years! 

[Michele]

So glad it helped!