tci ED Coding & Reimbursement Alert - 2018 Issue 6

Denials: Payers Issue Fresh Denials for Repeat Chest X-Rays, EKGs

Remember to use modifiers when necessary to denote medically necessary repeat tests. If your ED has suddenly seen payments drop for repeat chest x-rays and EKGs, you aren't alone. Knowing exactly why you faced the denial is important, because some such issues can be remedied with the simple use of modifiers. Background: Duplicate denials for chest x-rays or EKGs have been identified as a common error by several Medicare Administrative Contractors (MACs). For example, according to Palmetto GBA's recent posting on the issue, denials for these services are climbing rapidly because providers don't appropriately bill the repeat services. The...

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