payment reduction

  1. K

    Wiki Help! Add-On codes being reduced for MPR

    Hello, We have a few add-on codes being reduced by 50% by Virginia state Medicaid. They are stating that MPR applies. I'm trying to find the resources that show they aren't supposed to be reduced. I saw 2 knowledge base articles on AAPC but they are several years old and the links are not...
  2. J

    Wiki MPPR

    Hi everyone! If there is a trauma case, and a vascular surgeon performs a vessel repair alone and than assists in a bowel anastomosis, would the bowel anastomosis (with an 80 modifier) still be subject to the multiple procedure payment reduction?
  3. J

    Wiki Multiple Procedure Payment Reduction

    Does anyone have a link to written documentation regarding multiple procedure payment reduction for surgeries 3-5 performed same day being reduced to 25% of the fee schedule? I am struggling to find documentation I can provide to my provider who is questioning if this is accurate reduction...
  4. A

    Wiki Aetna shorting single-patient payments

    Has anyone experienced receiving EFTs that are short on the payment amount without any type of takeback on their single-patient payments? This has only happened on remittances with 1 patient on them. This just began happening to less than 2 months ago. I've called Aetna and the representatives I...
  5. A

    Wiki Modifier 55 payment reduction

    Does anyone know what Medicare pays when you use a modifier 55? I've searched everywhere. I know it's discounted due to only assuming post op care but trying to find out how much. Thank you!
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