tci Part B Insider - 2008 Issue 6

PART B REVENUE BOOSTER: Success Story: Fight Your Carrier if You've Used Modifier 59 Properly

This practice fought its carrier--and wonYou don't have to eat the cost of modifier 59 denials if you-re sure you-ve applied it correctly.The problem: One Part B carrier began denying a practice's claims when the physician would biopsy a skin lesion and destroy a common wart, both on the same site.The solution: This practice fought back and won after hiring an independent arbitrator to investigate the insurer's decision.Today we-ve got three steps that can help you overturn your modifier 59 (Distinct procedural service) denials when warranted.Step 1: Know when you-ve used modifier 59 properly. -Our...

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