Demystifying E/M and Modifier-25: Compliance Made Easy

Event Materials (Key Required)

The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) have identified the misuse of Modifier 25 as a significant compliance concern. Improper application of this modifier can lead to upcoding, resulting in substantial penalties. Commercial payers also scrutinize claims involving Modifier 25, as incorrect usage may indicate billing for services that are not significant or separately identifiable. Therefore, accurate application of Modifier 25 is crucial to avoid audits and ensure compliance with federal and payer-specific billing regulations. This webinar is designed to provide healthcare professionals with a comprehensive understanding of Evaluation and Management (E/M) services and the correct application of Modifier 25. This session will delve into the complexities of Modifier 25, clarifying common misconceptions and offering practical guidance to ensure accurate coding and billing practices.

Learning Objectives:

• Understand the criteria that constitute a “significant, separately identifiable” E/M service when performed on the same day as another procedure
• Identify documentation requirements to substantiate Modifier -25
• Learn the appropriate scenarios for appending Modifier 25 to E/M codes
• Gain insights into the necessary documentation to substantiate the use of Modifier 25
• Ensure adherence to payer policies and reducing the risk of audits
• Identify frequent errors and challenges associated with Modifier 25 usage
• Discover strategies to overcome documentation and coding errors

Areas Covered in the Session:

• Importance of E/M and Modifier 25 compliance
• Understanding Modifier 25: Definition and Purpose
• Evaluation and Management (E/M) Services
• Defining “Significant and Separately Identifiable”
• Differentiating between routine and additional services
• Global Periods and Minor Procedures
• Essential Documentation Practices
• Avoiding common documentation pitfalls
• Overview of payer-specific requirements
• Frequent Errors in Modifier 25 Application
• Strategies for Accurate Coding
• Detailed case studies illustrating correct and incorrect Modifier 25 usage
• Live Q&A Session

Suggested Attendees:

• Physicians
• Physician Assistants
• Nurse Practitioners
• Certified Nurse Midwives
• Medical Coders
• Medical Billers
• Compliance Officers
• Hospital Administrators
• Practice Managers
• Revenue Cycle Staff

Presenter Biography:

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Additional Information:

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to hear clearly

For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

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