tci Medicare Compliance & Reimbursement - 2023 Issue Q1

Industry Notes: Prepare to Stop Using CR Modifier and DR Code Starting May 12

If your coding staff are used to adding the CR modifier and the DR code to claims associated with the COVID-19 public health emergency (PHE), get ready for that to end on May 11. Reminder: The CR modifier (Catastrophe/disaster related) and DR condition code (disaster related) are required after a PHE is declared and formal waivers ensue. This is mandated by Section 1135 of the Social Security Act and outlined in the Medicare Claims Processing Manual, Chapter 38, Section 10. In 2020, the Centers for Medicare & Medicaid Services (CMS) added insight on the modifier and code usage for...

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