Category: CPT

Modifier 59 Is Over-Used and Abused, MAC Says

May 3, 2020October 25, 2022Barbara Cobuzzi, MBA, CPC, COC, CPC-P, CPC-I, CENTC, CPCONo Comments

Failure to adopt the X[ESPU] modifiers may be putting your practice at risk for Medicare fraud. Modifier 59 Distinct procedural service continues to be the most-used modifier among Medicare Part B providers, according to Novitas, and it is sending up … For more, read here: AAPC Blog

New Patient E/M Denials: Mystery Solved

January 21, 2020June 28, 2022Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in t… For more, read here: AAPC Blog