Provider/Supplier Type(s) Impacted: Providers that bill surgical services.

Reason Codes: 572, CO45

Claim Coding Impact: Type of service (TOS) 2 and 8 procedure codes with a bilateral indicator of “1”.

Description of Issue: Beginning May 2022, claims may have an inappropriate payment allowance for bilateral procedures billed with an RT and/or LT modifier.

Noridian Action Required: Noridian made system updates 07/07/22 to resolve the issue.

Provider/Supplier Action Required: No action required.

Proposed Resolution/Solution: Noridian will perform mass adjustments to correct any overpayment or incorrect payments.

08/04/22 - Noridian initiated the mass adjustments.

Date Reported: 07/14/22

Date Resolved: 08/04/22