tci Part B Insider - 2009 Issue 43

MODIFIERS: New Medicare Modifiers Throw Practices for a Loop

Key: Know how to report professional component. CMS introduced three new modifiers effective last January, but confusion still lingers about how to use them -- and MACs are not amused. When practitioners perform erroneous surgeries, CMS requires the hospital outpatient department, ASC, physician, or other entities to append one of the following three modifiers to the surgical code, effective Jan.15, 2009: • PA -- Surgery wrong body part • PB -- Surgery wrong patient • PC -- Wrong surgery on patient. "Unfortunately, the introduction of these new modifiers has caused much confusion and they are often being submitted...

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