Novitas Solutions recently released a Modifier 50 Fact Sheet. It’s reminding to 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…
Modification of the MCS Claims Processing System Logic for Modifier 59, XE Modifier, XS Modifier, XP Modifier, and XU Modifier Involving the National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) Column One and Column Two Codes. 59 Modifier, XE Modifier, XS Modifier, XP Modifier, and XU Modifier are among the NCCI-associated modifiers. The Multi-Carrier System…
HCPCS Modifiers List 2020: MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical conditionMB Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet accessMC Ordering professional is…
Looking for the United healthcare physical therapy billing guidelines? The modifier “GN, GO or GP” will be required on Always for “Therapy codes” to align with the Centers for Medicare & Medicaid Services (CMS). According to CMS, certain codes are “Always Therapy” services regardless of who performs them, and always require a therapy modifier —…
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 (MACs) will begin accepting AUC related modifiers on claims for advanced diagnostic imaging services furnished to Medicare Part B patients. The voluntary participation period ends December 31, 2019. During this…
The new Molecular Pathology coding guidelines changes will be effective from dates of service on and after Sept. 1, 2019. American Medical Association (AMA) guidance provides Claim Designation codes in the Molecular Pathology coding guidelines Gene Table that represent specific genes that are being tested. UnitedHealthcare will require care providers to append the AMA Claim…
The modification to the claims processing logic for modifiers 59, XE, XS modifier, XP, and XU.These modifiers were being processed only when applied to the Column 2 code in a bundled pair, per NCCI, with a modifier indicator “1.” This meant if the separate procedure modifier was appended on the Column 1 code, the modifier…
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 no mention of the role of the assistant surgeon in the body of the operative note; it was assumed the assistant surgeon provided an extra set of hands to execute…
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 component of the global fee) for computed radiography services Similarly, if such X-ray services are furnished during CY 2023 or a subsequent year, a payment reduction of 10 percent applies…
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 oxygen equipment, contents and supplies and is subject to adjustment depending on the amount of oxygen prescribed (liters per minute (LPM)) and whether or not portable oxygen is also prescribed….