tci Medicare Compliance & Reimbursement - 2007 Issue 6

PHYSICIANS: Warning--Use 77 Modifier And Make Sure Your Diagnosis Codes Are Different

Crackdown may hit your subspecialty consults extra hard.Heads up: You may be seeing a wave of denials when your cardiologist sends a patient to an electrophysiologist for an extra consult. Learn how to fight those denials below.For the past year, carriers have been cracking down on consult billing, say billing experts--and cardiologists and their sub-specialties have been especially hard hit.The scenario: A cardiologist sees a patient in the hospital for a consult. The cardiologist passes the patient onto a colleague, an electrophysiologist, for another consult on arrhythmia or some other electrophysiologic problem. The problem: Carriers have...

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