Breaking News! The Modifier 25 may not be the revenue “protection” modifier it once was known as for many physician’s practices. Terry dives right in this week to the recent headlines from payers like Anthem Blue Cross, and Independence Blue Cross Blue Shield, and their new 2018 policy amendments:
- When a minor surgical procedure code (0 or 10-day global period) is reported on the same day as an E/M code by the same physician, payment for the E/M code will be reduced by 50 percent.
- When a preventative/wellness exam and a problem-oriented E/M are billed during the same encounter, payment for the problem-oriented E/M code will be reduced by 50 percent.
CMA and AMA were able to scale back Anthem’s policy to 25% but you will continue to have an uphill battle as this new policy may become the new norm. You don’t want to miss this important news update and solution packed Podcast on how to fight back.”
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BS, CPC, CCC, CEMC, SCP-CA, ACS-CA, CCS-P, CCS, CMSCS, CMCS, CMC, QMGC, QMCRC
Ms. Terry Fletcher is a healthcare coding and billing consultant based in Southern California. With over 30-years experience, Ms. Fletcher teaches over 100 specialty coding Seminars, Teleconferences and Webinars every year. You can find her CodeCast™ podcast series, focusing on Physician Coding, Billing, Reimbursement, compliance, and Medical industry revenue opportunities, on iTunes, Stitcher, TuneIn, and Google Play.