tci ED Coding & Reimbursement Alert - 2005 Issue 11

Know When to Cut Your Cut of Reimbursement

How to make smart decisions about appropriate modifier 52 useAppending modifier 52 can significantly lower your payment for services such as foreign-body removal, infusion, and x-ray interpretation in the ED, so it pays to hone your instincts about when--and when not--to report it with your procedure codes. Take stock of this expert advice before you drop your next modifier 52 claim. Add Up Procedure Percentage Modifier 52 (Reduced services) is appropriate when procedures accomplish some result but don't fully complete the requirements of the procedure's description, says Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, senior instructor and director with...

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