tci Part B Insider - 2016 Issue 11

Appeals: NGS: You Can Add Modifiers, Op Notes Only During This Stage of Appeal

One Part B MAC illuminates the five appeal stages in crystal clear detail. It happens from time to time—you submit a claim, but realize after you get a rejection letter in the mail that you missed a key detail that would have prompted the payer to reimburse you for the claim. Fortunately, you can add that information during the first level of appeal, said NGS Medicare’s Gail O’Leary during the MAC’s March 15 webinar, “The Appeals Process and How to Avoid Appeals.” How Redetermination Can Work for You There are five levels of...

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