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tci E/M Coding Alert - 2023 Issue Q3

News You Can Use: Heed Cigna’s Proposed Change to Forestall Denials

Beware: The claims submission process may become more restrictive. Commercial carrier Cigna has proposed a change to their payer policies for providers seeking reimbursement for same-day procedures and evaluation and management (E/M) encounters. While the change has been delayed, as of publication, understanding the implications is important for retrieving the money your providers have earned. Know what Cigna proposed so you can avoid denials. Go Deep on the Details Cigna received multiple concerns from advocacy groups when the payer proposed lifting the pause in the implementation of its revamped modifier 25 (Significant, separately identifiable evaluation and management service by...

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