DecisionHealth, DecisionHealth - 2012 Issue 8 (August)

Avoid billing patients directly for grafts with RCR; use 22 modifier instead

Be careful about billing the patient directly for services, such as graft augmentation with rotator cuff repair (RCR), that your payer bundles or denies as inclusive. In many cases, the separate payment isn’t warranted and could cause your practice compliance troubles down the road.

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