From the American Academy of Ophthalmology

The Centers for Medicare and Medicaid Services has announced that Medicare administrative contractors will reprocess denied claims related to National Correct Coding Initiative (NCCI) edits implemented on July 1. No action is required by ophthalmologists for the claims to be reprocessed. The denials are the result of a computer system issue that fails to recognize the appropriate modifiers (-24, -25, -57). The new edits apply to any global surgical code billed with an established patient eye-visit code appended with one of the appropriate modifiers. CMS indicates that the denied claims will be reprocessed by Nov. 15.

For more information, contact the Academy’s Governmental Affairs Division at 202.737.6662