Consistent misuse and abuse of modifier 59 has put it on the Office of the Inspector General’s (OIG) active investigation radar. Meaning they are just waiting for you to slip up.
To make matters worse, 59 sub modifiers (XE, XS, XP, XU) and varying carrier guidelines, make it even more difficult for you to apply them correctly. In fact, CMS Transmittal 1422 projected error rates for modifier 59 at $320 million in physician claims and $450 million in facility claims.
Considering the size of these projected overpayments, you can rest assured that CMS and its auditors is sitting up and paying close attention and will be working hard to recoup this reimbursement.
So, what does this mean to you?
If you’ve been paid for claims that are found to have modifier 59 applied incorrectly, you’ll be expected to give that money back. And if that leads to a full scale audit of your modifier 59 claims, you could also have to pay fines for the overall erroneous coding behavior on claims going back years. Remember, Medicare fines are $10,000 for each occurrence. That means each time you’ve billed modifier 59 on the line of a claim incorrectly you would have to pay a $10,000 fine.
Your only defense is to take action, and the special report, Modifier 59: Misused and Misunderstood is the answer. It will help you get a firm handle on complying with modifier 59 guidelines – including the four new sub-modifiers –XE, XS, XP and XU.
You can trust the information in this special report because it was prepared and reviewed for accuracy by coding expert: Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO.
Inside the Report:
Here are just a few of the practical strategies you’ll receive by utilizing the proven strategies in this step-by-step special report:
WARNING: You may think that if you don’t bill Medicare you don’t have to worry about this, but think again. Although this specific to Medicare – private insurers are quickly following suit.
And remember, ignorance is not an acceptable defense against fraud violations. If you are targeted for an audit and are found to be applying modifier 59 and its sub modifiers incorrectly, or if your documentation doesn’t back up their use, you could be hit hard legally and financially.
Who Will Benefit:
Don’t risk it, order this must-have special report today and finally understand these complex and dangerous modifiers. ORDER TODAY!
CEUs: This expert report meets AAPC guidelines for 1.0 CEU. Requires successful completion of a Post-Test for Core A and all specialties except CIRCC for continuing education units.
Meet Your Expert: Kim Garner-Huey - MJ, CHC, CPC, CCS-P, PCS, CPCO
Kim is an independent coding and reimbursement consultant, providing audit, training and oversight of coding and reimbursement functions for physicians.
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"If you are going to submit even one claim with modifier -59 this year this special report is a must for your office.
It takes this tricky modifier and breaks it down into plain English so you can submit it correctly the first time."
- Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO
"An excellent simplification of a confusing problem."
- Maxine Lewis, CMM, CPC, CPC-I, CPMA, CCS-P