In Coding
Dec 20th, 2018
The National Correct Coding Initiative (NCCI) bundles evaluation and management (E/M) service and same day immunization administration (IA) codes, (e.g., CPT® 90460-90474). As a result, providers may face rejected claims when reporting an E/M service and same day immunization administration. The key to overcome these denials is to document precisely, and to append modifier 25 Significant, ...
In Billing
Sep 6th, 2018
The American Medical Association (AMA) sent a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma on Aug. 27, 2018, with signatures from medical societies with comments on the CMS proposal for the Patients Over Paperwork initiative. AMA Loves Paperwork Reduction In the letter, the AMA says that they support CMS’ initiative ...
In Billing
Mar 1st, 2018
Anthem has sent a letter to the AMA to announce  they are rescinding the policy reducing payment for physicians when billing an E/M with a modifier 25 and a procedure that has zero or 10 global days. Anthem was planning on taking a 25 percent reduction on all 25 modified services billed with minor procedures as ...
Modifier 25 is not a free pass to bill separately both services. By Ellen Hinkle, CPC, CPC-I, CPMA, CRC, CEMC, CFPC, CIMC, CSCG, AAPC Fellow Reporting an evaluation and management (E/M) code in addition to an injection administration code is not a given. Specific requirements must be met before you can append modifier 25 Significant, ...
In Coding
Oct 18th, 2017
Generally, wound care involves assessment and management of the wound, cleansing of the wound, simple debridement, and removal and reapplication of the wound dressings. In most cases, it is inappropriate to report an E/M service in addition to a wound care service (e.g., debridement, application of an Unna’s boot, etc.); however, if during the wound ...