tci Medicare Compliance & Reimbursement - 2017 Issue 19

Non-Physician Practitioners: Append Modifier SA on NPP Claims Now or Risk Denials, One Private Payer Says

Tip: Not all payers require modifier SA for non-physician practitioners performing an E/M. E/M services are amongst the most common claims in healthcare, remaining the bread-and-butter of many Medicare providers’ businesses. But reporting this basic care just got harder under one private payer. You’ll now need to append modifier SA to the E/M code if a non-physician practitioner performed the service and your patient is insured with UnitedHealthcare. The news: According to UnitedHealthcare’s June 2017 Network Bulletin, the payer has a new policy for claims with dates of service on or after Sept. 1, 2017. “UnitedHealthcare...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.