Has anyone ran into issues when billing back braces? We are credentialed to dispense back braces with CGS. We received payment for them and then years later we are asked to refund the money due to the patient having a same or similar product. Is there a way to prevent this from happening? If the patient does not inform us they have received a back brace before how are we to know to bill it with the replacement modifier? We can appeal and state that it was a replacement and was billed incorrectly, however we do not have medical necessity justifying a replacement since patient did not inform us. Please help!