Auditing modifiers--the two-digit codes attached to procedure codes to alter their descriptions--plays a key part in verifying that claims for healthcare services were filed accurately and processed ...

The -59 modifier is used to report a “distinct procedural service”. Proper use of the -59 modifier can result in payment for services that are usually denied when performed in the same case. This is ...

In September 2014, the U.S. Dept. of Health and Human Services’ Office of the Inspector General (OIG) published its audit of Tulare Regional Medical Center, an acute care hospital in California. In ...

Prior to the pandemic, Medicaid program coverage of audio-only telehealth services was limited. During the early stages of the pandemic, Medicaid beneficiaries were significantly less likely to ...