tci General Surgery Coding Alert - 2020 Issue Q3

Reader Questions: Use COVID-19 Signifiers for 'Formal Waiver' Claims

Question: Are Medicare providers supposed to be using the CR modifier or DR condition code on COVID-19-related claims? SuperCoder Subscriber Answer: Yes, according to CMS guidance. “With the exception of telehealth services, use of the ‘DR’ condition code and ‘CR’ modifier are mandatory for institutional and non-institutional providers in billing situations related to COVID-19 for any claim for which Medicare payment is conditioned on the presence of a ‘formal waiver,’” CMS says in the agency’s brief, “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing.” Reminder: The CR modifier...

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