BC Advantage - 2008 Issue 1

Modifier 25... The OIG Hasn't Lost Its Edge

Don't think the Office of Inspector General (OIG) has lost interest in modifier 25.Hardly. The OIG plans to continue monitoring claims for use of this particular modifier due to a reputation that raises a red flag. The modifier identifies a separate service for billing so its presence in claims naturally attracts OIG attention, especially when claims in which it was used has resulted in millions of dollars in improper payments. In 2001, according to the 2006 OIG work plan, Medicare allowed over $23 billion for evaluation and management services. Of that amount, approximately $1.7 billion was for...

To read the full article, sign in and subscribe to BC Advantage.

Access to this feature is available in the following products:
  • BC Advantage, 30+ CEUs & Webinars

free demo
request yours today
for any budget
sign IN
welcome back!