Channel Sponsor - Coding/Billing/Collections

Sponsored by National Medical Billing Services | info@nationalASCbilling.com | (636) 273-6711

What to know when billing modifier -25 — 3 key pointers

Several commercial payers have adopted stricter reimbursement policies to deny modifier -25 claims upfront, according to Joette Derricks, a healthcare compliance and revenue integrity consultant who spoke to Medical Economics.

Medical Economics outlined three tips for avoiding denials related to modifier -25:

1. Apply the modifier to the evaluation and management code, rather than the code for the procedure.

2. Document why the additional E/M service was necessary.

3. Be cautious about using the modifier for pre-scheduled and repetitive procedures, such as skin tag removals or pain injections.

More articles on coding, billing and collections:
Delaware pain physician indicted in $12.7M Medicare fraud scheme
6 new spine-focused ASCs this year
Aurora Health Care opens $55.5M outpatient surgery center

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months