tci Part B Insider - 2019 Issue Q3

RAC Audits: Auditors Home in on Modifiers for Discontinued Procedures

Find out what RACs are reviewing. Occasionally, you’re forced to discontinue a procedure before the patient is even 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 the new audit issue posted by Part B 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 a way for hospitals...

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