tci General Surgery Coding Alert - 2016 Issue 12

Reader Question: Beware Modifier 'Solutions'

Question: When we see a claims denial in our practice, some of our staff is quick to resubmit the claim with a modifier to “solve” the problem. That doesn’t work so well. Do you have some guidance about this that I can share with the staff? SuperCoder Subscriber Answer: According to at least one Medicare Administrative Contractor (JA MAC Part B), using a modifier in the wrong way is one of the most common reasons for claim denial to begin with. And quickly re-submitting with a different modifier doesn’t solve the problem. In fact, “adding...

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