Tuesday, July 6, 2010

What is CB modifier

CB Modifier

Description : Services Ordered by a Dialysis Facility Physician as Part of the ESRD Beneficiary’s
Dialysis Benefit, is not Part of the Composite Rate, and is Separately Reimbursable.

Required for Claims : End-Stage Renal Disease (ESRD) Facilities
Type of Bill: 72X
{NOTE: This modifier affects consolidated billing rules for skilled nursing facilities (inpatient)}

Coding Guidelines : The –CB modifier may only be applied for services related to the dialysis treatment and ordered by the dialysis facility physician.

General Guidelines
The provider may use the modifier ONLY when it has determined that:
• a beneficiary has ESRD entitlement;
• the test is related to the dialysis treatment for ESRD;
• the test is ordered by a dialysis facility;
• the test is not included in the dialysis facility’s composite rate payment; AND
• the beneficiary is in a Medicare Part A stay (type of bill 21X or 22X)

ESRD related diagnostic tests refer to:
• the beneficiary must be an ESRD beneficiary;
• the test must have been ordered by an ESRD facility;
• the test must relate directly to the dialysis treatment of the beneficiary’s ESRD

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