In Billing
Feb 25th, 2019
The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional XE, XS, XP, and XU) on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative ...
When a surgery calls for more than one surgeon, append the right modifier to capture everyone’s payment. Complex surgeries may require the efforts of more than a single surgeon. When this occurs, documentation and coding requirements (especially modifier application) become more intricate, as well. Read on to learn the basics for submitting these claims cleanly. ...
Understanding the appropriate use of modifiers 24, 25, and 57 ensures proper payment. Modifiers 24, 25, and 57 are often misunderstood. Each modifier has specific circumstances for use. Proper application of these modifiers will yield higher reimbursements for your providers, regardless of the clinical scope of your practice. The 2018 CPT® code book defines these ...
Feb 21st, 2018
Sometimes coders are confused when they should apply modifier 58 Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period and modifier 78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure ...
In Billing
Feb 14th, 2018
There are new and changed modifiers to use if you are adjusting oxygen volume. The Centers for Medicare & Medicaid Services (CMS) updated an October Transmittal better defining how to report oxygen amounts below 1 liter per minute, which reduces the fee schedule monthly amount for stationary oxygen by 50 percent. CMS’ rules for  volume adjustment say if ...