Advanced Search

Cardiology Coding Alert

Part 1:

Bolster Your Modifier PA, PB, and PC Know-How in 3 Steps

Published on Wed Jan 27, 2010

Are you guilty of this simple modifier 26 mistake? Deciding to assign a "wrong surgery" modifier is serious business, so arm yourself with the facts so you and your practice can make an informed decision. These three steps will get you on your way. 1. Identify 3 Types of 'Wrong' Services Medicare will not cover surgical or other procedures when the physician performs one of the following: • A procedure on the wrong body part • A procedure on the wrong patient • The wrong procedure. Impact: If you bill and receive reimbursement for procedures that meet any of the above conditions, you could face a recoupment request in the future. "If the doctor made a mistake, the patient should not have to pay for it, nor should the insurance company," explains Christine M. Bitner, CPC, CPC-I, chart abstraction specialist at HCA Physician Services in Brentwood, Tenn. Watch for: Medicare [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Cardiology Coding Alert

View All