Why was my office visit denied when billed on the same surgery date of service?

Answer:
Modifiers may be required to receive payment for some evaluation and management (E/M) services, if unbundling is not evident. Please review the CMS Global Surgery resource listed below and refer to the Modifier Lookup Tool that is located on Palmetto GBA’s website for further direction regarding your billed date of service.

Resources: CMS MLN Global Surgery Booklet

Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

Click to Chat Now