[Provider] PB and PC modifiers

[Provider Notification]

ATTENTION:  MaineCare Providers using "PB" and "PC" modifiers 

 

Some providers are continuing to submit claims with modifiers "PB" and
"PC". The modifiers "PB" and "PC" were discontinued by CMS more than
five years ago.  They were re-instated on July 1, 2009 with the
following descriptions:

 

PB- Surgical or other invasive procedure on wrong patient 

PC- Wrong surgery or other invasive procedure on patient

 

If these modifiers are inadvertently submitted on or after July 1, 2009,
and claims are paid, this would be considered an overpayment.  Under
Chapter I, Section 1.12-2 A, the provider must then report the
overpayments. 

 

If overpayments are not reported, then the Department will, as a result
of a review, contact the provider and request repayment.   

 

If you have any questions, please contact Customer Service at
1-800-321-5557 option #8.  

 

Is your mailing address up to date with MaineCare?  Please keep
MaineCare up to date so your Remittance Statements and checks arrive on
time.  Call Provider Enrollment at 1-800-321-5557 Option #6.  

 

If you would rather not get these e-mails, visit MaineCare's List Serve
Subscription
<http://www.maine.gov/dhhs/bms/member/innerthird/listserv.shtml>  page
to unsubscribe.

 

This is a one-way communication.  Do not reply to this e-mail.  Your
e-mail will not receive response.  If you have questions, please call
1-800-321-5557.  

 

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