Tag Archive | "Modifiers"

Meet the Latest Modifier-Related RAC Topics

Thursday, November 21, 2019

0 Comments

You may know that medical coding modifiers can affect payment and bundling rules for your claims, but did you know modifiers are on the radar for Recovery Audit Contractors (RACs), too? Here are some of the recently added audit issues that have links to modifier use. Quick background: Medicare’s RAC program is used to identify […]

Continue reading...

Learn Coronary Artery Anatomy According to CPT® and CCI

Thursday, August 22, 2019

0 Comments

When your job is converting medical documentation into codes, your knowledge of medical anatomy has to be shipshape. But you’ve got the added complication that the code set you’re using may have its own definitions for specific terms. Case in point: CPT® guidelines set out five major coronary arteries with coronary artery branches for only […]

Continue reading...

Add These AUC-Related Modifiers to Your Imaging Claims in 2020

Monday, August 12, 2019

0 Comments

At the end of July, Medicare released a set of modifiers that you need to know if you’re involved in ordering or coding for imaging. The modifiers, effective Jan. 1, 2020, are part of Medicare’s changes related to Appropriate Use Criteria (AUC) for advanced diagnostic imaging services. Check out the AUC-related modifiers below and then […]

Continue reading...

Here’s Why the MPFS Should Be at the Top of Your Modifier Checklist

Monday, February 25, 2019

0 Comments

When you think of the Medicare Physician Fee Schedule (MPFS), fees might be the first word that comes to mind. But modifiers should be a close second. Here’s how you can use the MPFS to improve your modifier accuracy for Medicare claims. Start here: To read about the MPFS bilateral indicator and modifier 50, read […]

Continue reading...

Which Modifier Goes First? Get Clued In or Face the Consequences

Tuesday, July 12, 2016

0 Comments

You’ve got a claim with a code that requires modifier 26 (Professional component) and modifier 50 (Bilateral component). Which should you append first? According to J8 Part B MAC WPS, the Multi-Carrier System (MCS) for claims processing has specific requirements. Buck the system and processing delays may be your reward. Put Pricing Modifiers First to […]

Continue reading...

6 Tips Help You Differentiate Distinct and Repeat Procedures

Wednesday, March 14, 2012

0 Comments

Whether to report modifier 59 (Distinct procedural service), 76 (Repeat procedure by same physician) or 77 (Repeat procedure by another physician) can become complicated if are not sure if your physician’s procedures were similar to or exactly the same as other services performed on the same patient on the same day. Here are some tips […]

Continue reading...