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Two New Reports from Office of Inspector General

Posted by: Robert Markette
December 13, 2005

Use of Modifier 59 to Bypass Medicare's National Correct Coding Initiative Edits  (OEI-03-02-00771)
 
This report determined that Modifier 59 was used incorrectly about 40% of the time.  This resulted in $59 Million in improper payments. 

 

Download Use of Modifier 59 report here. 

 

 

Use of Modifier 25  (OEI-07-03-00470) 

This report found that 35% of claims allowed under this modifier did not meet program requirements.  This resulted in improper payments totaling $538 million.

Download Use of Modifier 25 report here. 

         

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