Adopting Appropriate Claim Denials Management System: Modifiers 76/77

We have identified providers who are submitting several appeals for modifiers 76 and/or 77 and this has caused additional work for your organization as well as National Government Services. Appeals can be avoided if the claim is submitted with all services performed on one day. You can prevent unnecessary claim denials, appeals, and overpayments by monitoring your claims processing system to generate one claim for all services (including repeat procedures) of diagnostic tests. Make sure that one claim is submitted for all procedures performed on one day.

By adopting this process providers will increase revenue and eliminate extra paperwork saving your organization time and money. We are committed to ensuring accurate and timely responses to appeals. We are seeking your assistance in support of our mission and thank you in advance for your cooperation.

Posted 4/7/2020