DecisionHealth, DecisionHealth - 2009 Issue 8 (August)

Denials remain high for low-level, same day E/M services

Make sure your practice is using modifier 25 correctly when billing an additional E/M service with a procedure. A Part B News analysis of CMS billing data shows denial rates for lower-level E/M codes billed with the modifier are well above 20%. Experts believe you and your peers are appending modifier 25 (significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) with minor procedures such as an injection.

To read the full article, sign in and subscribe to the DecisionHealth Newsletters.

Thank you for choosing Find-A-Code, please Sign In to remove ads.