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Modifier Coding Alert

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Understanding modifiers is key for accurate medical coding and billing. One of the top billing errors determined by federal, state, and private payers involves the incorrect use of modifiers. If your practice is falling victim to this problem, you could face unnecessary claim denials, wasted follow-up time, lost revenue, OIG investigations, and more.

Whether you are looking out for guidance on modifier 25 to claim a “significant, separately identifiable evaluation and management service on the day of surgery,” are confused about use of modifiers during global surgery period, want to capture additional reimbursement with modifier 22, or need clarification on when modifiers 51, 52, and 59 apply, Modifier Coding Alert has you covered.

Every month, you will get how-to article on different modifiers. You’ll find payer spotlights which detail a particular payer’s guidelines for a modifier, specialty-specific modifier case studies, up-to-the-minute modifier news, and more, along with reader questions from coders just like you.

Here's a sample of some of the topics we've covered in the Modifier Coding Alert:

  • Crack down on denials by knowing how global periods factor in.
  • Eliminate 3 modifier mishaps that could be costing your practice money.
  • Read on to learn where to find the information you need to ensure you are billing every test your provider performs correctly, whether it is a unilateral or bilateral test.
  • Learn which modifier you can use when billing 93010, 93016, 93018, and 78452.
  • Know why you need to consult your payer about the need for modifier AI.
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