March 1999 AAOS Report
Examples of CPT coding mistakes needed
Any experiences that members may have had with insurance companies refusing
to recognize CPT modifiers or inappropriately bundling services together
is being sought by the Academy. The Academy and American Medical
Association have become increasingly concerned with the failure by
some insurance companies and managed care plans to follow CPT guidelines.
Members are asked to list specific examples (including the name of the payer)
where modifiers have not been accepted or where claims-editing software
has inappropriately bundled distinct procedures or services.
These examples will be used to educate payers about appropriate use