decisionhealth Newsletters, Coder Pink Sheets - 2023 Issue 3 (March)
Mind your modifiers: Prepare for a tough new modifier 25 policy from Cigna in May
Subscribe or sign in to view the full article.
Article Overview
This premium article covers a payer policy change from Cigna that affects office E/M claims submitted with minor procedures and modifier 25. It is aimed at coders, billing staff, and compliance-focused practices that need to understand the general documentation and review issues raised by the policy and the broader payer scrutiny around these claims.
Why This Topic Matters
The article helps practices anticipate a payer review change that could affect claim submission, documentation workflows, and denial risk for office visits billed alongside procedures.
Article Sections
-
Cigna policy update
Introduces the payer’s prepayment review update, its timing, and the general category of claims affected.
-
Documentation and billing considerations
Discusses the documentation review practices may need to perform and the broader compliance concerns raised for office E/M services billed with procedures.
What You Will Learn
- What type of payer policy change is being introduced
- Which broad claim category is affected
- Why documentation review matters for affected office visits
- What compliance issues practices may want to evaluate before the policy takes effect
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance personnel
- Physician office staff
Codes Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com