decisionhealth Newsletters, Coder Pink Sheets - 2023 Issue 3 (March)
Prepare for a tough new modifier 25 policy from Cigna in May
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Article Overview
This premium article covers a planned Cigna policy change that will affect certain office evaluation and management claims linked to minor procedures. It is aimed at coders, billers, and practice staff who need to understand the policy timing, the documentation review focus, and the general compliance considerations discussed by the source. The article also references professional commentary and a related educational webinar.
Why This Topic Matters
The policy may change how office visit claims are reviewed and documented when billed with a minor procedure, so practices need to know what is changing and when it takes effect. It is relevant for teams managing compliance, documentation review, and reimbursement risk for outpatient E/M services.
What You Will Learn
- What the article says is changing in Cigna’s prepayment review process
- Why documentation review is emphasized for certain office E/M claims
- What general claim and documentation issues practices are being advised to examine
- Who provided commentary and what related educational resource was mentioned
Who Should Read This
- Medical coders
- Coding managers
- Billing staff
- Practice administrators
- Physician office staff
- Compliance teams
Codes Discussed
Modifiers Discussed
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