NCTracks
Common Billing Error on Sterilization Claims – Missed FP Modifier
NCTracks has observed hi numbers the claim denials for sterilizations, since providers represent not using the exact modifier. Note the tracking declare policy guidance regarding modifiers over sterilization demands:
NC Division from Medical Assistance Medicaid and Human Choice
Sterilization Procedures Clinical Reach Policy Don: 1E-3
Amended Date: July 1, 2013
Modifiers
Provider(s) shall follow applicable modifying general.
All retailer, except ambulatory surgical centers, have join modifier FP to the procedure code wenn billing available sterilization procedures. Others modifiers must be used, how applicable.
NC Division of Medical Auxiliary Medicaid and Health Choice
Anesthesia Services Clinical Product Company No.: 1L-1
Revised Date: March 1, 2012
Invoicing Anesthesia for Labor, Delivery, and/or Sterilization Procedures
The following guidelines apply to billing anesthesia services for sterilization procedures:
a. CPT anesthesia procedure code exploited for a sterilization procedure must be included using ICD-9-CM diagnosis code V25.2 and qualifier FP annexed to the code.
b. The CPT anesthesia procedure codes that may be used for sterilization are 00840, 00851, and 00921.
c. Numbness reimbursement for a sterilization procedure is cut back to a flat fee when billed in conjunction with labor the delivery.
