|Home » Categories » Miscellaneous Issues|
|Article Number: 388 | Rating: Unrated | Last Updated: Mon, May 23, 2011 7:46 PM|
Our facility has just found out there is a -AY modifier that is new. What do you do when lab tests requested have various dx as well chronic renal disease, do you add -AY modifier and to what?
The AY modifier was created as a way for non ESRD facilities to identify laboratory tests and a handful of drugs that are now fall under consolidated billing if these services are provided by a non ESRD facility and are not related to the treatment of ESRD. An excerpt from MedLearn Matters 7064 published January 14th is provided below.
CR 7064 provides an ESRD consolidated billing requirement for limited Part B services included in the ESRD facility bundled payment. Certain laboratory services and limited drugs and supplies will be subject to Part B consolidated billing and will no longer be separately payable when provided for ESRD beneficiaries by providers other than the renal dialysis facility. Should these lab services, and limited drugs be provided to a beneficiary, but are not related to the treatment for ESRD, the claim lines must be submitted by the laboratory supplier or other provider with the new AY modifier to allow for separate payment outside of ESRD PPS. ESRD facilities billing for any labs or drugs will be considered part of the bundled PPS payment unless billed with the modifier AY. In addition, as noted above, Medicare will, however, allow separate billing for ESRD supply HCPCS codes (as shown on attachment 4 of CR 7064) by DME suppliers when submitted for services not related to the beneficiary’s ESRD dialysis treatment and such services are billed with the AY modifier.
There are no attachments for this article.
Viewed 492 times since Fri, Dec 7, 2012
Recovery Room Service
Viewed 7217 times since Tue, Nov 6, 2012
Viewed 1213 times since Wed, Sep 28, 2011
holter monitor charges
Viewed 3102 times since Fri, Aug 5, 2011
Viewed 2460 times since Tue, Sep 20, 2011
Requirements Of An Order
Viewed 1036 times since Wed, Aug 29, 2012
Viewed 1169 times since Thu, Jun 23, 2011
Viewed 1206 times since Mon, May 16, 2011