• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Mod 25 on all E&M claims

Create Wiki
U

us063958

Guest
Messages
16
Best answers
0
Besides the possibility of triggering an audit, is there any compliance issue for putting Modifier 25 on all E&M' claims, just in case a procedure is done?
 
Thank you for your advice. I just learned that some of the billers I work with are doing just that. Besides incorrect coding are there any ramifications, such as compliance fraud, that I can share with the group?
 
I would ask them to tell you WHY they do this. My guess is that they are doing this because 1) someone has told them that this is the way it is always done, or 2) do it this way to get paid. See if any of them can give you a valid response to the use of modifier 25 and it's significance. My bet is that they can't. Then you can rehearse to them the issues of fraud and abuse and how that the OIG is very interested in such billing practices and that they'd better have a good answer ready. Just some thoughts from one who loves E/M but is challenged by it and its modifier companion on a daily basis---Suzanne E. Byrum CPC
 
You must log in or register to reply here.
Top