tci Part B Insider - 2009 Issue 6

MODIFIERS: Focus on Modifier 79 Compliance -- Before Your Carrier Does

Our tips help you report modifier 79 the right way. CMS wants to make it crystal clear: If you are reporting modifier 79 (Unrelated procedure or service by the same physician during the postoperative period), your claims better be airtight, or you'll be hearing from your MAC. On Feb. 13, CMS issued transmittal 442, which advised contractors to "strengthen program safeguards to prevent improper payment for modifier 79." This came on the heels of an OIG report indicating that modifier 79 had a vast potential for fraud. To make sure you're reporting modifier 79 properly, check out these...

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