10+ Usha Martin Interview Questions and Answers

The difference between 25 modified and 15 and modifier

• 25 modified refers to a value that has been altered or adjusted in some way

• 15 and modifier implies the combination of the number 15 with a modifier

• The specific context and purpose of the modification or modifier are not provided

If Medicare denies the claim as a captition, we need to take certain steps to address the issue.

• Review the denial reason provided by Medicare

• Check if the claim was submitted correctly and all necessary documentation was included

• Identify any errors or missing information in the claim

• Contact the Medicare Administrative Contractor (MAC) to discuss the denial and seek clarification

• Submit an appeal if the denial was incorrect or unjustified

• Provide any additional supporting documen...read more

The global period time frame can be checked on the CMS website.

• The CMS website provides information on the global period time frame for medical procedures.

• The global period is a period of time during which all related services for a specific procedure are considered part of the initial procedure.

• The global period time frame varies depending on the procedure and can range from 0 to 90 days.

• By visiting the CMS website, one can access the Medicare Physician Fee Schedule (MPFS) d...read more

A crossover reason code is a code used to identify the reason for a customer switching from one product or service to another.

• Crossover reason codes help businesses understand why customers are leaving and make improvements to retain them.

• These codes can be used in customer surveys, feedback forms, or data analysis to categorize the reasons for customer churn.

• Examples of crossover reason codes include price dissatisfaction, poor customer service, product quality issues, or be...read more

Inclusive denial refers to the act of denying access or opportunities to individuals or groups based on their characteristics or identities.

• Inclusive denial is a form of discrimination that excludes certain individuals or groups from participating in social, economic, or political activities.

• It can occur in various contexts such as employment, education, housing, healthcare, and public services.

• Examples of inclusive denial include refusing to hire someone based on their race,...read more

Caption is a text that provides a description or explanation for an image or video.

• A caption is typically displayed below or beside the image or video it describes.

• It helps provide context, clarify content, or add additional information.

• Captions are commonly used in social media posts, news articles, and presentations.

• For example, a caption for a photo of a beach could be 'Enjoying a sunny day at the beach.'

NCC edits are a set of rules used by insurance companies to determine the appropriateness and accuracy of medical claims.

• NCC edits stand for National Correct Coding edits.

• They are developed by the Centers for Medicare and Medicaid Services (CMS) and used by insurance companies to prevent improper payments.

• NCC edits compare the codes submitted on medical claims to identify any discrepancies or errors.

• These edits help ensure that the services billed are supported by appropriate...read more

The 22 modifier is a billing modifier used in medical coding to indicate that a procedure was discontinued due to extenuating circumstances.

• The 22 modifier is used to report a procedure that required additional time, effort, or complexity beyond the usual

• It is typically used when a surgeon encounters unexpected difficulties during a procedure

• The 22 modifier can result in increased reimbursement for the procedure

• For example, if a surgeon needs to remove a tumor that is larger ...read more

The 59 modifier is a coding modifier used in medical billing to indicate a distinct procedural service.

• The 59 modifier is used to identify procedures or services that are separate and distinct from other services performed on the same day.

• It is used to bypass the National Correct Coding Initiative (NCCI) edits and allow separate payment for the additional procedure or service.

• The 59 modifier should only be used when no other more specific modifier is available to accurately d...read more