tci Part B Insider - 2013 Issue 28

Part B Mythbuster: Using Modifier 57? Then Ditch Modifier 25 on That Claim

Medicare carriers don’t require you to append both modifiers. Tips passed around from coder to coder at classes and conventions can be incredibly helpful when filling out your billing forms—but they can also hurt you if you take the wrong advice. Such has been the case for several practices who contacted the Insider recently noting that they were told to stop using modifier 57 because “payers don’t like it” and to use modifier 25 instead when filing decision for surgery claims. Although this may be true of some specific payers, it isn’t a blanket...

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