When you have distinct, separate procedures, know which modifiers will get the claim paid in full.Modifier 59 Distinct procedural service acts as a “universal unbundling” modifier for… Read More »Proper Usage of Modifier 59
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
CMS established two Healthcare Common Procedure Coding System (HCPCS) Level II modifiers to identify 340B-acquired drugs: Modifier “JG” Drug or biological acquired with 340B drug… Read More »Modifiers for 340B-acquired drugs
Same Provider, Same Number of Views When the same provider reads the same number of pre- and postreduction views, he or she will report two… Read More »Radiology Billing and Coding: Postreduction X-rays
The Medicare National Correct Coding Initiative (NCCI) has Procedure to Procedure (PTP) edits to prevent unbundling of services, and the consequent overpayment to physicians and… Read More »X{EPSU} Modifiers
Medicare Contractors will consider payment for unused and discarded portion of a single-use drug/biological product after administration of the appropriate (reasonable and necessary) dosage for the… Read More »Billing and coverage for drug wastage
Based on three recent widespread probes of office evaluation and management (E/M) services, First Coast Service Options (FCSO) has discovered that the 24 modifier for… Read More »Documentation is required when billing modifier 24