Wednesday, July 7, 2010

Catastrophe/Disaster Related modifier

CR Modifier

Description : Catastrophe/Disaster Related.

Required for Claims : Claims for Hurricane Katrina/Rita and other disaster victims

Coding Guidelines : The –CR modifier may only be applied for services related to the disaster victims.

General Guidelines :

Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of a disaster (e.g. Hurricane Katrina/Rita), will be:
• paid for services provided; and
• exempt from sanctions for noncompliance (unless it is discovered that fraud or abuse occurred).

To facility claims processing and track services and items to victims of disasters (e.g. Hurricane Katrina/Rita) and any future disasters, CMS has established a new condition code (“DR”) and modifier for providers to use on disaster related claims.

The new codes are for use by providers submitting claims for beneficiaries who are
disaster patients in any part of the country.

For institutional billing, either the condition code or modifier may be reported.

�� The condition code “DR” would identify the claims that are impacted or may be impacted by specific payer policies related to a national or regional disaster.

�� The modifier “CR” would indicate a specific Part B service that may be impacted by policy related to the disaster.

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