DecisionHealth, DecisionHealth - 2016 Issue 6 (June)

Mind your modifiers: Keep a close eye on descriptors to avoid bilateral-based denials

Don’t rely on the short descriptor. When you think it is appropriate to use a bilateral modifier, check the code’s full descriptor. Payers are taking steps to eliminate the inappropriate use of bilateral modifiers and at least one major payer has built edits based on code descriptors to do so.

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