General Question for the Week of April 26, 2021

Question:

From a claims perspective, what are some red flags when reviewing infusion and injection claims?

Answer:

Two areas to watch are:

The total number of units reported – If more than one unit is reported, review the encounter to verify that the appropriate number of units have been charged.
Use of modifiers – If modifiers are reported for an infusion, compare the line item to other charges on the claim to ensure appropriate modifier use.

TAGS: CPT, Infusion & Injections

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

General Question for the Week of April 26, 2021

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