Billing reminders: RTLT modifiers, DWOs, ABNs

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Friday, February 15, 2019

WATERLOO, Iowa – HCPCS codes that require the RTLT modifiers need to be on two separate claim lines effective for dates of service beginning March 1, VGM has alerted providers. Currently, it’s acceptable to use one claim line with two units of service with RTLT…VGM has also reminded providers that they can complete detailed written orders for CPAP accessories, with the exception of the physician’s signature and signature date. VGM says that DWOs are not required prior to delivery but are required prior to submitting claims for reimbursement. “Best practice is to obtain all the necessary information prior to delivery to make for a smoother transaction,” it says…Do providers need ABNs for non-assigned claims? The short answer is no, VGM has advised providers. The reason for denial on the ABN can’t state, “Claim is non-assigned because the reimbursement is lower than my cost.” ABNs are issued when there is reason for denial, such as lack of medical necessity, same/similar equipment, upgrades and overutilization, VGM has reminded providers.

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