Showing posts with label CR modifier. Show all posts
Showing posts with label CR modifier. Show all posts

Friday, February 25, 2011

Modifier CR - Emergency health care needs of beneficiaries and providers

Modifier CR Fact Sheet

Definition:
• Emergency health care needs of beneficiaries and providers affected by Hurricane Katrina and any future disasters

Facts:
• Enacted to ensure Medicare programs will be flexible in order to accommodate the emergency health care needs of beneficiaries and medical providers in the states devastated by Hurricane Katrina.
• Many of the programs’ normal operating procedures have been relaxed to speed the provision of health care services to the elderly, children, and persons with disabilities who depend on the services.

Because of hurricane damage to local health care facilities, many beneficiaries have been evacuated to neighboring states where receiving hospitals and nursing homes have no access to patients’:

• Health care records;
• Current health status; or
• Verification of status as Medicare or Medicaid beneficiaries.

Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be:

• Paid for services provided; and
• Exempt from sanctions for noncompliance (unless it is discovered that fraud or abuse occurred).

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.

Saturday, May 29, 2010

Disaster/Emergency-Related CR and ER modifiers

Use of the CR Modifier and DR Condition Code for Disaster/Emergency-Related Claims

Policy:

The DR Condition Code:
• The DR condition code is used for institutional billing only.
• Use of the DR condition code is required when a service is affected by an emergency or disaster and Medicare payment for such service is conditioned on the presence of a “formal waiver” (as that term is described in “Background”, above)
•Use of the DR condition code also may be required when either the contractor or CMS determine that such use is needed to efficiently and effectively process claims or to otherwise administer the Medicare fee-for-service program.
• The DR condition code is used at the claim level when all of the services/items billed on the claim are related to the emergency/disaster.


The CR Modifier:
• The CR modifier is used for Part B items and services only but may be used in either institutional or non-institutional billing.
• Use of the CR modifier is required when an item or service is impacted by an emergency or disaster and Medicare payment for such item or service is conditioned on the presence of a “formal waiver” (as that term is described in “Background”, above)
• Use of the CR modifier also may be required when either the contractor or CMS determine that such use is needed to efficiently and effectively process claims or to otherwise administer the Medicare fee-for-service program.

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