Practice Management

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  • 1.  RESEARCH MODIFIERS

    Posted 05-16-2019 13:40
    ​We do the professional interpretations for our local hospital, who have some patients involved in clinical trials.  In a phone meeting it was brought up that we should be billing clinical research modifiers (Q1)  along with a NCT research number in box 19.   The hospital has been billing this since 2014 and I found out this week.  We are getting paid for our services with no problem.   Is it necessary since we operate under different tax id number to bill these modifiers and research trial numbers?  Any help would be appreciated!

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    Dawn Krueckeberg
    Billing Operations Manager
    Fort Wayne Radiology
    Fort Wayne
    260-469-4766
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  • 2.  RE: RESEARCH MODIFIERS

    Posted 05-17-2019 10:16

    Hi Dawn,

     

    I can't speak to the necessity of filing using the clinical trial info, but I'm surprised you're getting paid for these exams from Medicare. Commercials will pay without the trial information, but Medicare usually won't pay without it. I have a client that does the professional read at a hospital under their own tax ID. We have to file our clinical trial patients to Medicare with the Q1 mod, Z00.6 Dx code as primary, as well as including the NCT number. If all three aren't on the Medicare claim, we get denials.

     

    Janene Markuske

    Client Manager – Radiology

     

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    C     727-753-9331

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    An end-to-end ecosystem designed to empower radiologists and outpatient centers to flourish despite the never-ending headwinds facing the industry