All Entries Tagged With: "modifier -79"

CMS increases its scrutiny of modifier -79 for multiple procedures

Last week, CMS published a One Time Notification related to modifier -79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period) and the global surgical package (GSP). The GSP is a feature of Medicare’s payment system for physicians and so at first blush this transmittal would appear not to apply to hospital providers. However, CMS’ business requirements apply to both carriers (who traditionally process physician claims) and fiscal Intermediaries (who traditionally process hospital claims), indicating that CMS is concerned about modifier -79 usage in both settings. [more]