Claim Denials: Brace for Intensified Scrutiny of 'G' Modifiers
Without standardized procedures, Medicare has overpaid almost $744 million in 2011 alone.
The HHS Office of Inspector General (OIG) wants to stop inappropriate payments when MACs allow claims which have a ‘G’ modifier. Read on for the skinny on what’s being targeted.
Refresher: The G modifiers are meant to indicate that a denial is expected, which actually paves the way for alternate payments in many cases.
On May 3, the OIG sent the Centers for Medicare & Medicaid Services (CMS) its report entitled Medicare Payments for Part B Claims With G Modifiers, which revealed that MACs often...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: