tci Medicare Compliance & Reimbursement - 2005 Issue 40

REHAB: Rehab Providers Must Now Deal With NCCI

Remember to use modifier 59 to unbundled services.The world of National Correct Coding Initiative edits now includes outpatient rehab services. Providers can follow this expert advice to ensure that they handle these changes with confidence--and protect their payments.This means providers cannot bill some multiple therapies to Medicare on the same day for the same patient, unless they use the right modifier to unbundle the procedures. And if a provider is not watching closely, the new NCCI coverage will cut into its reimbursement for services reported to Medicare. Currently, the NCCI edits affect only PTs and OTs in...

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