In Coding
Jul 10th, 2019
Novitas Solutions recently issued a Modifier 50 Fact Sheet, reminding medical coders of the proper use for this CPT payment modifier. The Medicare Administrative Contractor (MAC) for jurisdictions H and L warns that, effective for Part B claims received on and after Aug. 16, 2019, services will be rejected as unprocessable when modifier 50 Bilateral ...
Jul 29th, 2015
By Nancy Clark, CPC, CPC-H, CPB, CPMA, CPC-I While recently reviewing claims, I noticed an area of “undercoding,” or coding for a lesser procedure than is documented in the medical record. Upon review, this particular issue also appears as a repeat offender of the Comprehensive Error Rate Testing (CERT) program on several Medicare Administrative Carriers’ ...
In CMS
Jun 15th, 2015
by John Verhovshek, MA, CPC Not every code is eligible for payment with modifier 50 Bilateral procedure appended. How do you know if you should append the modifier or leave it off? Maybe you should report two units of the code, instead? For Medicare payers, the ultimate source of information is the Medicare Physician Fee ...
In Coding
Jan 27th, 2015
The CPT® 2015 codebook deleted a familiar breast ultrasound code (76645), while adding two new, more precise codes to describe the same procedure. 76641 Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete 76642 Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited Code 76641 describes a ...
In Billing
Oct 17th, 2014
Modifier 50 Bilateral procedure can sometimes cause confusion because of the seemingly redundant anatomical modifiers RT (right) and LT (left). Although these modifiers may seem interchangeable, they are not. Bilateral surgery is defined as a procedure performed on both sides of the body at the same operative session or on the same day that is ...