Cardiology Coding Alert

Modifier PA: Catch this mid-surgery game-plan change exception. In a perfect world, you'll never need to apply Medicare's rule about properly coding surgery on a wrong body part. But mistakes do happen, so prepare with this explanation of when you should and shouldn't mark a service as "wrong." Recap: In the last issue, "Bolster Your Modifier PA, PB, and PC Know-How in 3 Steps" explained that if you submit a claim for an erroneous procedure, you must append the appropriate modifier to each line item related to that procedure so Medicare knows not to reimburse them. Next step: Even if you can keep the modifiers straight, you need to know when to apply them. Determining that the provider performed the wrong surgery (modifier PC) or worked on the wrong patient (modifier PB) may be fairly straightforward, but understanding "wrong body part" involves a little more detective work. Nail NCD Definition [...]