Part B Insider (Multispecialty) Coding Alert

Published on Mon Oct 14, 2013 PDF

Plus: Modifier 77 is your friend for diagnostic ER services.

Although the government shutdown hasn’t impacted your Medicare payments or your enrollment systems, it could still impact your bottom line. Officials in Washington, DC confirmed on Oct. 7 that the city would not make Medicaid payments during the shutdown, halting $89.2 million in payments that were expected to go out the door last week but did not, the Washington Business Journal reported.

Officials in the District of Columbia told providers to keep submitting claims as always, and that those claims would be paid after Congress opened the budget back up for payments, the article added.

Keep an eye on the Insider as the shutdown continues to find out if any additional programs are impacted by the freeze.

In other news…

If you forget modifier 77 (Repeat procedure or services by another physician or other qualified health care professional) in the emergency room, it could cost you.

Part B MAC NGS Medicare sent out a reminder on Oct. 10 stating that if practitioners provide a diagnostic service in the ER on the same date as a full service provider performs a service, the claim will be denied unless modifier 77 is appended to it.

You can read more on this topic in the Medicare Claims Processing Manual at www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c13.pdf.