Misuse of modifiers 25 and 59 puts your practice at risk

Your practice is at risk for a costly audit and a big repayment demand if you incorrectly attach modifiers 25 and 59 on your Medicare claims. Government auditors have targeted these two modifiers in the past and found:

  • 35% of claims using modifier 25 (significant, separately identifiable E/M service) didn’t meet requirements – totaling $528 million in improper payments.
  • 40% of code pairs billed with modifier 59 (distinct procedural service) did not meet CMS’s rules – resulting in $59 million in improper payments.

That’s money your practice could keep if your staff avoids committing easily correctable errors.

Join billing and coding expert Margie Scalley Vaught and she’ll teach you how to appropriately use these modifiers, ensuring proper reimbursements for the services you provide.

During this 90-minute, interactive webinar you will receive:

  • Real-life billing scenarios showing how-to use the modifiers correctly and ensure your practice is reimbursed for services.
  • The documentation requirements you need in order to attach either of the modifiers to a claim so you get paid.
  • Direction on which service codes on claims get the modifiers.
  • The main reasons physicians receive denials for improperly using modifiers 25 and 59, raising red flags to auditors.

 

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