HCPCS Modifiers: MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected… Read More »New HCPCS Modifiers Effective from Jan 1, 2020
The modifier “GN, GO or GP” will be required on Always for “Therapy codes” to align with the Centers for Medicare & Medicaid Services (CMS).… Read More »United Healthcare Commercial Reimbursement Policy Updates effective from Sep 1st, 2019
From January 1, 2020, marks the start of the Appropriate Use Criteria (AUC) program educational and operations testing period, at which time Medicare Administrative Contractors… Read More »Advanced Imaging Claims Require New Modifiers and G Codes Effective January 1, 2020
Modification of the MCS Claims Processing System Logic for Modifier 59, XE, XS, XP, and XU Involving the National Correct Coding Initiative (NCCI) Procedure to… Read More »Modifier 59 Changes in PTP edits
The modification to the claims processing logic for modifiers 59, XE, XS, XP, and XU.These modifiers were being processed only when applied to the Column… Read More »PTP edits Changes in modifier 59 Examples
In mostly the documentation for assistant surgeons consisted of only the name of the assistant surgeon in the operative note header. Most often there was… Read More »Assistant at Surgery Modifiers Require Specific Documentation
Beginning January 1, 2018, and including Calendar Years (CY) 2018-CY 2022, a payment reduction of 7 percent applies to the technical component (and the technical… Read More »Modifier FY
Medicare pays a monthly fee schedule amount for oxygen and oxygen equipment per beneficiary. For stationary oxygen equipment, this monthly fee schedule amount covers the… Read More »Revised and New Modifiers for Oxygen Flow Rate
Description: Ordering Professional Consulted A Qualified Clinical Decision Support Mechanism For This Service And The Related Data Was Provided To The Furnishing Professional. Effective date: July… Read More »Modifier QQ
Beginning Jan. 1, 2018, clinicians may report on Medicare Part B claims submitted for items and services the applicable HCPCS Level II modifiers established for… Read More »Modifier X1-X5