tci Part B Insider - 2015 Issue 19

Part B Coding Coach: Inject New Life Into Your Inhaler Service Claims by Answering 3 Questions

Judicious use of modifiers 25 and 59 will pay you more -- if you know how to navigate the rules. Your reimbursement success in reporting inhaler services hinges on three factors — the purpose of the device used, use of correct modifiers and the fulfilling the documentation requirements. Answer these three questions competently to arm yourself with the knowledge for avoiding denial of payment for this service. 1. Was the Inhaler Service Used As Treatment Or Demonstration? There may be two reasons why your physician or nonphysician practitioner (NPP) initiates inhaler services for a patient. First is for inhalation...

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