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Click here for more sample CPC practice exam questions and answers with full rationale

BCBS denying E/M codes with 25 modifier

I do billing for five different practices across Texas and am having an issue with BCBS. They are denying most E/M codes when we use the 25-modifier (to distinguish from other services rendered the same day). I’ve gotten dozens of these so far. I have read some info online from different practices that BCBS is going to reduce reimbursement on E/M’s when billed with the 25-modifier to 50% of the allowed amount. But I haven’t seen anything in black and white from BCBS itself. Does anyone have any hard information on this change? The dozens of appeals are KILLING me. Maybe I shouldn’t have taken on five practices:eek:.

Medical Billing and Coding Forum