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Newbie CPB here - I am sending a claim to Humana Medicare Advantage for 95076 and 95117 (oral challenge and allergy injection). I know I need to add a modifier, but what line should I add it to? And recommendations?
It used to be that it had to be appended to the Column 2, however MCR now allows 59, or the X modifiers on either Column 1 or Column 2. It doesn't matter which one it is appended to. This is provided it is appropriate and the documentation supports Modifier 59 use. There could be commercial or other payers that do not follow this.
It still seems weird to me to do it that way so I append it the "old way." You can look up NCCI edits with an edit checker or on the NCCI website. https://www.cms.gov/medicare-medica...e/medicare-ncci-procedure-procedure-ptp-edits