JD Supra

Use of Modifier 25 - 2017 Medicare Physician Fee Schedule Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) have reviewed the use of Modifier 25 to unbundle payments for evaluation and management (E/M) services when ...
Becker's ASC

When to Use CPT Modifiers 25 & 57

Current procedural terminology modifiers 25 and 57 may be confusing to some coders, but each serves a specific purpose, according to an AAPC report. For an evaluation and management visit when a ...
Becker's ASC

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 ...
Becker's Hospital Review

RACs’ Upcoming Part B Audits Likely to Focus on Modifier -25 Usage

When RAC contractors start complex reviews of Medicare Part B claims, they will likely hit practices in a weak spot, physicians’ use of CPT modifier -25, according to a report by the RAC Monitor.
JD Supra

OIG Increases Scrutiny of "Modifier 25"

Medicare payment rules normally do not permit additional payments to physicians for evaluation and management (E/M) services performed on the same day as a therapeutic procedure. However, if the E/M ...
HealthLeaders Media

Reporting Separately Payable E/M Services with Modifier -25

In general, Medicare considers E/M services provided on the day of a procedure to be part of the work of that procedure. Q: A patient with a history of hypertension and high cholesterol visits a ...