Paper Claims Billed with Incorrect Modifiers to be Returned as Unprocessable
Beginning September 1, 2014, paper claims that are billed with incorrect modifiers will be returned as unprocessable. For instance, if code L1840 (knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom-fabricated) is billed with an NU modifier, the claim will be rejected and returned, because NU is not a needed modifier for L1840. Previously, these claims were manually corrected and processed by CGS. This change is being made in order to be consistent with electronic claims (electronic claims with incorrect modifiers are rejected by CEDI). Click here to read the full story.