Practice Management Alert

Plus, Cigna launches cost estimator software.

Effective April 27, Cigna has significantly reduced the amount of supporting documentation youll need to submit with claims that include modifiers 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of a procedure or other service) and 59 (Distinct procedural service).

Background: Previously, Cigna had announced a change to its reimbursement policy, set to take effect on April 20, that would have required you to submit documentation for as many as 17,000 pairs of services. However, Cigna reduced the number of pairings that require documentation to about 200 -- 73 code pairs for modifier 25 and 121 code pairs for modifier 59.

Cigna specifically identified two edit types with two modifiers (CMS/NCCI Incidental edits with modifier 25 and CMS Mutually Exclusive edits with modifier 59) to target the edits identified as having the highest modifier use increases from 2007 through 2008, according to Cignas Professional Claims Code Editing and Documentation Requirements Guidelines document.

More: You can find more about the documentation requirements, including the lists of affected code pairs, on the Cignas secureWeb site:  www.cignaforhcp.com.