Mar 1st, 2013
Arm yourself with coding tips to withstand payer scrutiny AND get paid. By David Peters, CPC, CPC-P Whether you work in a hospital, physician office, or other health care setting, gone are the days when claims are processed, paid, and filed away. Instead, claims are dissected, scrubbed, and analyzed for numerous data systems. How does your ...
Feb 1st, 2013
Overlooking these modifiers can result in improper reimbursement. By Terri Brame, MBA, CHC, CPC, CGSC, CPC-H, CPC-I Any coder worth his or her wage knows about modifiers 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service ...
Aug 1st, 2012
By Nancy Clark, CPC, CPC-I Modifiers are crucial in telling the story of the claim by identifying procedures that have been altered in some way without changing the core meaning of the code(s) submitted. Let’s look at the modifiers that can be appended to evaluation and management (E/M) codes used within the global period. The ...
Jul 1st, 2010
By Nancy Reading, RN, BS, CPC, CPC-I Proper application of evaluation and management codes (E/M) codes and modifier 25 Significant, separately identifiable evaluation and management service by same physician on the same day of the procedure or other service has been a longtime challenge for physician coders. More recently, the appropriate assignment of E/M service ...
Jun 1st, 2010
By G. John Verhovshek, MA, CPC Used appropriately, modifier 59 Distinct procedural service is a powerful reimbursement tool allowing for separate payment of distinct services that, under usual circumstances, would not be billed together. For this same reason, the modifier also allows ample opportunity for misuse and abuse. The competent coder will apply modifier 59 ...