tci Part B Insider - 2013 Issue 10

Appeals: Appeal Modifier 25 Denials With Confidence Using These 4 Strategies

Hint: Pay attention to global period assignments. Denials are a part of every practice’s existence. Some denials are warranted, but others may not be justified. With the crackdown on modifier 25 misuse, you may be seeing more denials involving this modifier. Before you chalk it up to a mistake, review the claim and take the following four steps to be sure you aren’t missing out on reimbursement. 1. Check Documentation Meets Modifier 25 Criteria You should first verify that your physician’s chart note supports billing an E/M with modifier 25 (Significant, separately identifiable evaluation and management...

To read the full article, sign in and subscribe to tci Part B Insider.


Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.