Outpatient Facility Coding Alert - 2011 Issue 16
Medicare Claims Errors: Part B Practices Still Making Modifier, Timely Filing Mistakes, One MAC Says
Subscribe or sign in to view the full article.
Article Overview
This article summarizes guidance from an NGS Medicare webinar on common Part B claim submission errors. It covers broad claim-denial topics such as modifier use, how Medicare contractors’ coverage materials fit into billing workflows, and updated timely filing requirements under federal law. The piece is aimed at providers, coders, and billing staff who handle Medicare Part B claims and want to understand the types of administrative issues that can delay or deny payment.
Why This Topic Matters
Claim denials and payment delays often stem from avoidable administrative mistakes. Understanding the general categories of Medicare Part B billing guidance discussed here can help practices determine whether the full article is relevant to their compliance and claims-editing workflows.
Article Sections
-
Use Modifiers Properly
Discusses common modifier-related claim submission concerns raised during the webinar and the importance of appropriate modifier selection. The section also includes a clinical example illustrating the broader issue.
-
Keep LCDs at Top of Mind
Explains the role of Medicare contractors’ coverage materials and related supplemental guidance in understanding procedure and service billing expectations. It also points readers to contractor resources and national Medicare coverage information.
-
Consider Timely Filing Rules
Covers Medicare claim filing deadlines and the broad policy change affecting when Part B claims must be submitted. The section notes the administrative consequences of missing the filing window.
What You Will Learn
- Which general claim submission issues Medicare Part B practices are still encountering
- How Medicare contractor guidance materials relate to billing and coverage questions
- What broad timely filing topics are discussed in connection with Part B claims
- Why modifier usage is a recurring source of denials and delays
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Compliance professionals
- Physician practices submitting Medicare Part B claims
Codes Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.


Quick, Current, Complete - www.findacode.com