Archive for The Day of June 7th, 2006
Archive for the Day of June 7th, 2006
Welcome to the medical billing blog archive for the day of June 7th, 2006.
Here you will find links to every article added to the Outsource Management Group web site during June 7th, 2006.
You can browse this day's archives by clicking the "More" button from any of the excerpts below.
Proper Usage of Modifier 59
The HHS Office of Inspector General (OIG) found that there is an enormous amount of claims in which modifier 59 is being misused. The misuse is completely unintentional and is largely due to the confusion this modifier causes with many practices when the medical coding is being generated. A random sample of 350 code pairings of samples was taken by the OIG. These random samples were ones that had bypassed the NCCI (National Correct Coding Initiative) edits by using the modifier 59. The OIG also found that about 40 percent of the code pairs they examined didn’t meet the requirements of the program. This translates to roughly $59 million dollars …
Correctly Using Modifier 22 in Your Medical Billing
In medical billing, modifiers can be just as important as the CPT codes they append. A simple mistake such as miss sequencing these codes could lead to incorrect reimbursements. There is one modifier that is known as being the most incorrectly used modifier: 22. Modifier 22 (Unusual procedural services) is used to indicate a substantial amount of extra work a physician needs to do for a specific procedure. As a matter of fact, there are some procedures that never get separately reimbursed unless modifier 22 is used in medical billing. The lyses of adhesions are one example of this. The lyses of adhesions are a procedure that is always bundled …
