tci Medicare Compliance & Reimbursement - 2007 Issue 15

CODING: Are You Using Basic Modifiers Correctly? Time To Double-Check

Billing and rendering provider must be in the same group.You may think you know your ABCs when it comes to billing and coding compliance, but one carrier is preparing to give you a spelling test.Cahaba GBA imposed a new set of "audit trail" edits starting March 1. They are looking to see if providers are following basic compliance on several billing and coding issues, including: • Use of LC/LD/RC modifiers for coronary procedures. If you bill for a coronary procedure without one of these coronary artery modifiers, you may face a denial. "RC" stands for right coronary...

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