tci Medicare Compliance & Reimbursement - 2015 Issue 13

Bilateral Billing: You Could Spend Hours on Bilateral Service Appeals

CMS confirms a pattern of inappropriate billing using multiple lines to bypass the MUEs. Do you know when to append modifier 50 on claims for two different line items? If not, there’s trouble ahead. Check out what the Centers for Medicare & Medicaid Services (CMS) reps had to say during the agency’s May 21 “Medically Unlikely Edits and Bilateral Procedures” podcast. Medicare claims processors are on the lookout for practices that report their bilateral services incorrectly, and the latest batch of medically unlikely edits (MUEs) will solidify the fact that if you don’t bill it...

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