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Pre-Requisite Visit: Before billing CCM services for a new patient or one not seen within the past year, an initiating visit is required specifically a comprehensive E/M visit, Annual Wellness Visit (AWV), or Initial Preventive Physical Examination (IPPE)

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This usually involves 3 to 5 shots given about a week apart

Using Medicares RT/LT two-line format for a commercial payer that accepts modifier 50 doesnt cause a denial, but using the modifier 50 single-line format for a Medicare contractor that expects RT/LT lines can trigger a bilateral edit that delays payment

(October 2013)