Medicare Compliance & Reimbursement

Recovery Audit Contractors:
RACs Ratchet Up Modifier 57 Scrutiny

Review CPT® and CMS guidance for best results. Modifiers can help you explain your services or special circumstances to a payer and gain the appropriate reimbursement. However, choosing the correct modifier can be a daunting task, leading to claims denials. One in particular, modifier 57 (Decision for surgery), can be particularly vexing and was recently added to the Recovery Audit [...]