CMS: Watch never-event modifier use

by CHARLES FIEGL on Oct 7, 2009

Avoid using the new never-event modifiers unless CMS requires you to add one to a claim. CMS says the agency has recently received claims with providers improperly using the new never event modifiers -- resulting in unnecessary denials.

You only use the following modifiers:

  • PA for a surgery performed on the wrong body part;
  • PB for a surgery performed on the wrong
    patient; and
  • PC for the wrong surgery performed on a patient.

You're required to report a never event to CMS. Medicare does not pay for never events, so you'll automatically receive a denial when you mistakenly use one of the three modifiers.

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