Identify EKG procedures requiring modifiers due to multiple being performed on the same day, and apply the appropriate modifiers (76 and 77) to prevent claim denials.
DOMAIN
Revenue Cycle Middle
FUNCTION
Coding
Category
Modifier Application
Status
Live
AUTHORING ORGANIZATION
University of Texas Southwestern
PERFORMANCE METRIC
Clean Claim Rate
Automation Tool
UiPath
TECHNOLOGIES
RPA
Applications
EPIC
HB | PB
N/A
Automation value
(as reported)
497523
Problem Statement
When multiple EKGs are performed for a patient on the same day, modifiers 76 and 77 must be applied to the first and subsequent procedures or the duplicate services are denied, a detailed coding judgment that is easy to miss at volume and directly lowers the clean claim rate.
Automation Solution
This automation identifies EKG procedures with multiple same-day occurrences and applies the appropriate 76 and 77 modifiers to the first and subsequent EKGs, preventing duplicate-service denials before submission.
Automation Resources
PDDs, Process Flows, Presentations, and Assessments
Tarpon Health Process Map - UTSW EKG Rhythm
Process Flow
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Tarpon Health PDD - UTSW EKG Rhythm
PDD
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Related Automations
No related automations
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Problem Statement
When multiple EKGs are performed for a patient on the same day, modifiers 76 and 77 must be applied to the first and subsequent procedures or the duplicate services are denied, a detailed coding judgment that is easy to miss at volume and directly lowers the clean claim rate.
Automation Solution
This automation identifies EKG procedures with multiple same-day occurrences and applies the appropriate 76 and 77 modifiers to the first and subsequent EKGs, preventing duplicate-service denials before submission.
Automation Resources
Tarpon Health Process Map - UTSW EKG Rhythm
Tarpon Health PDD - UTSW EKG Rhythm
Related Automations
Comments