Modifier Review, Be Sure You Are Not Setting Yourself Up for Audits
The use of modifiers can be challenging. Modifiers are used to change the meaning or further describe CPT® codes and could alter the reimbursement for services provided. In this session speaker will discuss modifiers as directed for use with: Evaluation and Management services, office-based procedures, surgical procedures and more! The session will also help attendees build a better understanding of specifically how the modifiers should be utilized. Extra emphasis will be placed on the more confusing modifiers, such as: 25, 51 and 59, 76, 77, 78, and 79, which are commonly misused. Expert speaker Stephanie Thomas will also cover HCPCS Level II modifiers.
- Modifier proper usage in uncertain times with payers. Examples of what NOT to do to “just get the claim paid”.
- How important physician documentation is in selecting appropriate modifiers, and how to collaborate and communicate effectively with providers to suggest addendums, or additional information to add to their records.
- EOBs are complicated and its difficult sometimes to understand what the REAL issue is with a claim-we will give some tips and tricks on this hot topic as well.
- Sequencing of modifiers to ensure proper payment and response.
- Prevent denials and claim issues by submission of proper modifiers on first billing.
- Identify specific payer requirements and how to find these for reference. Description and LOTS of examples of hard-to-understand modifiers.
- How to appropriately rebill if a modifier was changed or added.
- Modifier use and proper sequencing (Both CPT and HCPCS modifiers)
- Denials and how to prevent and address when received.
- Real world examples (LOTS) to show proper and improper usage.
- How to find payer specific guidelines on modifiers
- Audit documentation and learn to collaborate with providers to improve claim outcomes.
Who Should Attend
- Medical providers
- Billing team
- Front desk
- Pre auth specialists
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