Jul 29th, 2019
Payer-specific rules — especially rules that vary for every claim — not only make collecting revenue difficult, but also add to the cost of collection of monies earned by the physicians. A blog clarifies Novitas’ instructions for reporting modifier 50 when bilateral procedures are performed. The instructions from Novitas state that bilateral services should be ...
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 ...
In CMS
Mar 7th, 2016
CPT® 20610 Arthrocentisis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance describes aspiration (removal of fluid) from, or injection into, a major joint (defined as a shoulder, hip, knee, or subacromial bursa)—or both aspiration and injection of the same joint. The procedure may be performed for diagnostic ...
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 ...