Some Carriers Rejecting Claims That Use PT Modifiers, CMS Says

The Centers for Medicare & Medicaid Services has reported that some carriers are not recognizing the PT modifier for ASC claims, according to an Ambulatory Surgery Center Association release.

CMS officials have confirmed the failure to recognize the modifier is an error. The ASCA is working closely with CMS to identify carriers experiencing problems and correct the issue. ASCA asks those experiencing denials to fax a copy of the Explanation of Benefits provided by your carrier to ASCA at 703.549.0976.

Contact ASCA Director of State and Reimbursement Policy Marie Edler at medler@ascassociation.org with any questions.

Read the ASCA release on PT modifier rejection.

Read more on coding:

-AAPC Editorials Disagree on Effectiveness, Necessity of ICD-10

-CMS Clarifies KY Modifier Use

-3 Mistakes That Lead to Inappropriate Surgery Center Coding

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