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93224 medicare is appending a 51 modifier on code less $ 8.10

Monica Posted Thu 25th of April, 2013 18:06:06 PM

51 modifier

SuperCoder Answered Thu 25th of April, 2013 22:36:29 PM

93224 is on Medicare’s list of diagnostic cardiovascular services subject to the MPPR: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1149OTN.pdf

“The MPPRs apply to TC-only services, and to the TC of global services. For cardiovascular services, full payment is made for the TC service with the highest payment under the Medicare Physician Fee Schedule (MPFS). Payment is made at 75 percent for subsequent TC services furnished by the same physician (or by multiple physicians in the same group practice, i.e., same Group National Provider Identifier (NPI)) to the same patient on the same day.”

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