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Baron R, Saguer M

Do: Verify if the medication is separately reimbursable Use the appropriate modifier when needed (e.g., Modifier 25) Ensure documentation supports medical necessity Dont: Bill 96372 without a corresponding diagnosis code Assume its bundled unless mentioned in the payers policy Forget to link the drug (e.g., J codes) with the injection When in doubt, this is where smart revenue cycle management healthcare practices step in

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