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ASC Modifier 50 denial

Angela Posted Thu 03rd of August, 2017 14:24:27 PM
Is there a new/recent CMS rule that says ASC's cannot bill with a modifier 50? I recently was denied by Triwest (veterans program) when I billed 64483-50 and 64484-50. The remit denial stated the procedure code was inconsistent with the modifier/or a required modifier is missing. Per their customer service, I was informed that ASC's can no longer bill using 50 modifiers? They state their policies are in line with Medicare. Any thoughts?
SuperCoder Answered Fri 04th of August, 2017 04:39:07 AM

Hi Angela,

Some payers don't accept the 50 modifier, but want RT / LT instead. You may need to check with the guidelines of your private payer regarding the same. Please feel free to ask for further clarification. Thank you.

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