Proper Use of Modifier 50 (2021)

Proper Use of Modifier 50 (2021)

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…

Modifier 59 Changes in PTP edits

Modifier 59 Changes in PTP edits

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…

New HCPCS Modifiers

New HCPCS Modifiers

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…

Advanced Imaging Claims Require New Modifiers and G Codes

Advanced Imaging Claims Require New Modifiers and G Codes

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…

Modifier FY (2021)

Modifier FY (2021)

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…

Modifier QQ (2021)

Modifier QQ (2021)

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 1, 2018 Usage and guidelines: Used when the furnishing professional is aware of the result of the ordering professional’s consultation with a CDSM for that patient. Reported on the same…

Modifier X1-X5 (2021)

Modifier X1-X5 (2021)

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 patient relationship categories. Although the use and selection of these modifiers are not be a condition of payment, yet, clinicians should prepare for the likelihood of them becoming applicable components…