Medicare Compliance & Reimbursement

Reporting modifier 78 for a staged procedure? Expect denials. When it comes to appending CPT® modifiers to your codes, the rules can be daunting, and Medicare's regulations only compound the confusion. But if you're up to speed on these key modifier billing practices, you'll be raking in deserved pay. Check out the following five tips to ensure that you aren't missing any opportunities. 1. Don't Avoid Modifier 26. If your physician provides an interpretation and report for an x-ray or other radiological service in the treatment of a patient, that's not always just part of his E/M -- in some cases, you can separately bill for the interpretation and report by appending modifier 26 (Professional component) to the CPT® code. Typically, the technologist that performed the patient's x-ray will bill the code -- such as 71010 (Radiologic examination, chest; single view, frontal) -- with modifier TC (Technical component) to indicate that he is [...]