Modifier XU Examples

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such…

Revised Additional Documentation Request Limits

On November 6, 2015, the Centers for Medicare and Medicaid Services (CMS) released revised additional documentation request (ADR) limits for non-private practice settings. This would include skilled nursing facilities, home health agencies, rehabilitation agencies, comprehensive outpatient rehabilitation facilities and hospitals. This would apply to both Part A and Part B services and Part B services…

Modifier XS Examples

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such…

Upcoming Focus of Provider Specific Reviews

Novitas Solutions, Medicare Administrative Contractor for the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas, has announced their upcoming focus of provider specific reviews and to no ones surprise, some of the CPT codes to be reviewed impact outpatient physical and occupational therapy services. CPT codes 97112 (neuromuscular reeducation), 97140 (manual therapy)…

Modifier XP Examples

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such…