Note: NCCI associated modifiers are recognized for NCCI code pairs/related edits. For additional information please refer to the CMS website: http://www.cms.hhs.gov/NationalCorrectCodInitEd/ -26 Professional Component: Certain procedures are a combination of a...
The professional component (see modifier -26) for radiological services is intended to cover professional services, when applicable, as listed below: 1. Determination of the problem, including interviewing the patient, obtaining the history and making appropriate...
Modifier Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study Correct Use When a routine clinical service is performed as part of an approved clinical research study ...
Denial Reason, Reason/Remark Code(s) • CO-50, CO-57, CO-151, N-115 – Medical Necessity: An ICD-9 code(s) was submitted that is not covered under a LCD/NCD • Procedure codes: 93307, 93320, 93325 Resolution/Resources...
This component represents the transportation of the equipment to the patient. Establish local RVUs for the transportation R codes based on carrier knowledge of the nature of the service furnished. Carriers shall allow only a single transportation payment for each trip...
52 Modifier (Reduced Services) Procedures for which services performed are significantly less than usual may be billed with the 52 modifier. Procedure code defines the 52 modifier as “Reduced Services: Under certain circumstances, a service or procedure is...
