RARC M15
Separately billed services were bundled
Services billed separately were treated as components of the same procedure.
Why you actually get this
- The services genuinely are components of one procedure.
- A distinct-service modifier was needed and not applied.
How to check whether it’s correct
- 01Establish whether the services were performed at separate sessions or sites.
- 02Check whether a modifier distinguishing them applies.
Sometimes worth appealing
Travels with CARC 97. The question is the same: were these genuinely separate, and does the documentation show it.
Often arrives with
Seeing a lot of these?
A single denial is a claim to work. A pattern of the same denial is a process to fix, and the two need completely different responses. A free panel reads ninety days of your claims data and shows which codes actually recur for you.
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