tci Part B Insider - 2014 Issue 6

Physician Notes: Know Your Therapy Modifiers for Claims Success

Therapists who have been submitting claims to Medicare with the therapy modifiers for their services should start checking their modifiers a bit more carefully. That’s the word from a Feb. 6 MLN Matters article, which cautions therapists not to interchange their modifiers on claims. “Through analysis of original Medicare claims data, CMS has identified cases where claims for discipline specific evaluation codes have reported the modifier corresponding to another discipline,” CMS says in MLN Matters article MM8556. “For example, occupational therapy evaluations have been billed and paid while reporting a GP modifier (Services delivered under...

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