The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) have reviewed the use of Modifier 25 to unbundle payments for evaluation and management (E/M) services when ...
The postponement of Blue Cross Blue Shield of Michigan’s (BCBSM) proposed reimbursement policy affecting evaluation and management (E/M) services billed with modifier 25 marks a critical step in ...
Several commercial payers have adopted stricter reimbursement policies to deny modifier -25 claims upfront, according to Joette Derricks, a healthcare compliance and revenue integrity consultant who ...
In general, Medicare considers E/M services provided on the day of a procedure to be part of the work of that procedure. Q: A patient with a history of hypertension and high cholesterol visits a ...
When RAC contractors start complex reviews of Medicare Part B claims, they will likely hit practices in a weak spot, physicians’ use of CPT modifier -25, according to a report by the RAC Monitor.
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