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Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]
The post Cigna Updates Modifier 25 Payment Policy appeared first on AAPC Knowledge Center.
Oftentimes a patient’s “Oh, by the way …” comment turns an encounter that was scheduled as a preventive medicine visit or a minor office surgery into something more involved. When the provider goes above and beyond the physician work normally associated with a billable service or procedure, you may be able to report the separate […]
The post Are You Using Modifier 25 Correctly? appeared first on AAPC Knowledge Center.
On Jan. 14, coders and billers gained insight into proper use of novel HCPCS Level II modifier FT Unrelated evaluation and management (e/m) visit during a postoperative period, or on the same day as a procedure or another e/m visit. (report when an e/m visit is furnished within the global period but is unrelated, or […]
The post Append Modifier FT for Unrelated Critical Care Services appeared first on AAPC Knowledge Center.
A quick check of the NCCI PTP edits can pay off in a big way. Let’s say you’re cruising along in what I call the “coding world.” You’re using your bundling matrix software and come across two codes that have a National Correct Coding Initiative (NCCI) edit bundling them (one code includes the other). What […]
The post Modifier 59: Don’t Stop! Yield and Investigate appeared first on AAPC Knowledge Center.
Brush up on modifier 24 guidelines to ensure payment for postsurgical unrelated E/M services. Standard postoperative care, including related evaluation and management (E/M), is not separately reportable, but an unrelated E/M service during the postsurgical period may be. To alert the payer that an E/M service provided during the global period is not related to […]
The post Modifier 24: Determine How Your Payer Defines “Unrelated” appeared first on AAPC Knowledge Center.
Understand the additional work required to receive rightful payment on modifier 22 claims. Values assigned to CPT® codes assume an average service with an expected range of complexity. However, there are times when the code used to report a service does not adequately describe the work involved. When the procedure performed has exceeded the normal […]
The post Append Modifier 22 to Extraordinarily Complicated Procedures appeared first on AAPC Knowledge Center.
Understand modifiers for accurate coding and proper reimbursement.
The post Become a Modifier Virtuoso appeared first on AAPC Knowledge Center.
Understanding modifier 57.
The post Test Your Understanding of Modifier 57 appeared first on AAPC Knowledge Center.
Capture full payment for remote visits during the PHE for COVID-19. An interim final rule published in the April 6, 2020, Federal Register explains how to bill telehealth services during the COVID-19 public health emergency (PHE). The final rule goes into great detail, explaining why the place of service (POS) code 02 is not being […]
The post Using Modifier 95 for Telehealth Makes Cents appeared first on AAPC Knowledge Center.