Compliance Question of the Week

For the Week of April 15, 2019

Cardiology

Cardiology Question for the Week of April 15, 2019

Question:

When is it appropriate to use modifier 59?

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Laboratory

Laboratory Question for the Week of April 15, 2019

Question:

Can modifier 59 be assigned to both column-one and column-two codes listed in the procedure-to-procedure edits?

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Pharmacy

Pharmacy Question for the Week of April 15, 2019

Question:

When do retroactive payment corrections occur for certain drugs?

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Radiology

Radiology Question for the Week of April 15, 2019

Question:

Our radiologist interpreted a right upper and lower quadrant (RUQ and RLQ) ultrasound ordered by the ER physician. The spleen was not examined so we cannot assign code 76700. Is it appropriate to code 76705 twice and add a 59 modifier to the second one?

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Respiratory

Respiratory Question for the Week of April 15, 2019

Question:

How has the number of billable sessions changed for code G0424?

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General

General Question for the Week of April 15, 2019

Question:

What is a Medicare ACO?

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