Arthroscopy knee modifiers for 29881, 29876, 29877, 29874

Originally submitted by Anita Odum as a comment; moved to main posts. I know you are suspose to use modifier with these procedures. I was told 51, then 59. I know that if 29876 nd 29877 is done in the same compartment you use G0289 for 29877. Some one told me to use the 51 that 59 was wrong. Also, for the 29874 have to use also G0289. I'am confused. HELP. They said you could use two G0289 in the same procedures.

CMS FAQ: Who will Enforce HIPAA - posted 4/17/09

Note: This question was answered by CMS. Source: Who will enforce HIPAA? Feedback Who will enforce HIPAA? Answer States have the primary enforcement responsibility for group and individual requirements imposed on health insurance issuers, using sanctions available under State law.

CMS FAQ Can a Patient be billed if an ABN is signed and a service is denied due to MUE?

Note: This question was answered by CMS. Source: May an Advanced Beneficiary Notice (ABN) be utilized to bill the beneficiary for services denied due to an MUE? Feedback May an Advanced Beneficiary Notice (ABN) be utilized to bill the beneficiary for services denied due to an MUE? Answer

Red Flag Policy

Do anyone have information about the "Red Flag Policy" or where I can obtain information. Our practice received information stating the implementation date is May 1. I think it has something to do with the FTC and CMS...but I am really not sure. Any assistance would be greatly appreciated. Thanks Soneaqua

CMS Reversed Decision to allow Physicians to delegate to someone to enter PECOS Application

CMS has finally reversed their decision as to whether a physician can share their user name and password for the NEPPES in order for an employee or a contractor to enter the data into the PECOS Internet based Application for Physicians. However, CMS has indicated that when the physician signs the Certification required for the PECOS Application they are indicating that they have reviewed all of the data entered into the system and verify that it is correct.

Locum Tenens in the ED


posted here with permission by the author: Jim Blakeman of

Question: A couple of the physicians in our group are considered locums for purposes of our malpractice coverage. I'm wondering if that means any bills submitted using their NPI should have the Q6 modifier included.

**Medicare Learnresource articles for the week of 4/13/09**

The Centers for Medicare & Medicaid Services (CMS) released the following Learnresource articles this week. Visit the WPS Medicare Website at the addresses listed below for more information on the topics. * 2009 Physician Quality Reporting Initiative Program Updates! * CMS Now Accepting Suggestions for Potential 2010 Physician Quality Reporting Initiative (PQRI) Reporting Options