tci Medicare Compliance & Reimbursement - 2019 Issue Q3

Recovery Audit Contractors: Discontinued Procedure Modifiers Find Spot on RAC’s To-Do List

Tip: Documentation will help clarify usage. Sometimes, you’re forced to discontinue a procedure before a patient has been anesthetized. There are a few modifiers that can help you collect some reimbursement for this situation, even if you can’t bring in the whole procedure amount. But determining which modifier to use can be a challenge for some practices. According to a new audit issue posted by Medicare Part B Recovery Audit Contractor (RAC) Cotiviti on June 28, reviewers are looking at claims for procedures that are discontinued before anesthesia is administered. In black and white: “Modifiers provide...

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