Radiology Providers: Identical Services on the Same Claim

Palmetto GBA would like to remind providers of the importance of the correct use of modifiers when filing claims to Medicare.  Research has revealed that a number of radiology claims contained incorrect usage of CPT modifiers when billing for identical services on the same claim.  In the near future, we will begin to monitor these claims through our Palmetto GBA Advanced Clinical Editing (P-ACE) system. Providers who have claims submissions that meet this criteria will receive a ‘Smart Edit’ on your claims acknowledgement transaction report (277CA) signifying the need for correction and resubmission of your claim.

Applies to:
Jurisdiction 11 Part B//General
Jurisdiction 11 Part B//Radiology