Medicare Compliance & Reimbursement

Medicare Claims Errors:

Part B Practices Still Making Modifier, Timely Filing Mistakes, One MAC Says

Don't avoid checking LCDs to find out your MAC's rules. Appending modifier 59 to all of your claims willy-nilly to ensure that they go through will not get you paid faster in the long run -- it will have you seeing denials. That's the word from NGS Medicare's April 27 webinar, "Avoiding the Top Part B Claim Submission Errors," which focused on the main errors addressed by NGS Medicare, a Part B MAC in four states. Use Modifiers Properly Practices often submit claims with coding errors that cause claim denials and/or delays, and many of those involve improperly used modifiers, said NGS's Donna Pisani during the call. The NGS reps ran through tips for using several modifier issues, including the following, among others: Modifier 24: You'll report modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period) "for an unrelated E/M service that falls within the [...]
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