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HIPAA
Comprehensive Neurology 25000
A New York City Neurology Practice, Comprehensive Neurology PC has settled an alleged HIPAA violation for $25,000
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FDA Recalls
Coding
Coding Pearls - DMECODING - Modifier Issue?
“I billed A5500 and A5512 with modifiers -KX, -RT, -LT.
L1940 KXRTLT
L2330 KXRTLT
L2820 KXRTLT
I billed these on separate lines. This claim was rejected so we re-billed putting the KX modifier in the 3rd spot and it was still rejected for the same reason. The comment was: 4 – the procedure code is inconsistent with the modifier used or a required modifier is missing Any thoughts on how to tackle this denial?”
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MIPS
Bunion Pain REGCLR3
Description:
REGCLR3 measures the improvement in functions of patients with a diagnosis of Bunion Pain . Improvement is measured as a reduction in pain after an intervention. The patient must be treated, it is up to the medical provider to select the medically appropriate treatment. Treatments may include surgical intervention, shoe wear modifications, orthotics, and physical therapy.
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FDA Recalls
Coding
Coding Pearls - Multiple Skin Substitutes
“My billing team and I have a difference of opinion. If we apply more than one graft, they have been using modifier -76. It is getting paid, but I am not sure that is the appropriate use of the modifier. I just assumed that we would bill for total units. However, each graft has a unit number. So, if we bill double the units, we need a way to alert the insurance company why the units are doubled. This is why we started using the 76 modifier. Any input would be appreciated.”
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