tci Part B Insider - 2009 Issue 29

PHYSICIAN NOTES: CMS Reiterates Modifier 50 Advice for Providers Billing Facet Joint Injections

Plus: OIG comes down on inappropriate Medicare payments for pressure reducing support surfaces. Thanks to a 2006 OIG audit, MACs are on the lookout for incorrectly-billed facet joint injections, so it's time to scrutinize your claims. Medicare guidelines are very strict about when you can append modifier 50 (Bilateral procedure) to a facet joint injection code -- so you should know when to report this modifier versus when you must bill add-on codes instead. CMS revised MLN Matters article MM6518 (effective date August 31). In the article, CMS clarifies that you should append modifier 50 to your facet joint...

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