Advanced Search

Podiatry Coding & Billing Alert

FAQs:

Put A Stop To Modifier 25 Misuse and Abuse

Published on Sun Jun 20, 2010

Find out why the phrase "by the way" offers an effective insight.Many podiatry practices take modifier 25 as a go-to modifier whenever patients visit for any checkup or procedure, regardless of whether their situation really justified modifier 25. Usually, the intention is to recoup more reimbursement, says John F. Bishop, PA-C, CPC, president and CEO of Bishop & Associates Inc. in Tampa, Fla. As a result, modifier 25 doesn't serve its real function.Ask these 3 questions, and put the modifier into good use.1. Does A "BTW" Scenario Take Place?A very basic hint that tells you your claim might warrant modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) is to see if the patient had "by the way" (BTW) scenario. This is as good as checking if there was an additional work performed that went above [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Podiatry Coding & Billing Alert

View All