E/M modifiers are one of the largest drivers of E/M claim denials, get it right and your E/M denials can be reduced to almost nothing saving you time, and speeding up your payments. Get it wrong, and you could trigger an audit. Both government (RAC, OIG, Medicare) and private payers alike are using E/M modifiers as indicators to drive audits. And trust me, you don't want to be on their audit radar.
With so much at stake, wouldn't it be great if you could get someone to just tell you how to apply E/M modifiers correctly in plain English. Each modifier has its own nuance, and without a firm understanding of how to apply these modifiers, you are doomed to a sea of denials and lower-than-deserved reimbursements.
You can finally get the practical, step-by-step information you need to ensure you are correctly applying E/M modifiers from a nationally-recognized coding expert. Deb Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P, CDIP, will give you the inside scoop on how to more accurately apply E/M modifiers at her recorded training session. And even if you are a coding veteran, you are guaranteed to walk away from Deb's session with a new tool to boost your reimbursement or cut down on the hassle of fighting denials.
This session will provide you with valuable information packed with the specifics you need to report E/M services—and be paid correctly the first time. Modifiers are the essential tools in the coding process enhancing some codes, explaining details and indicating exceptions to rules in other settings.
Below are just a few of the practical, how-to modifier tactics you'll receive by watching this practical, how-to training session:
- Properly choose between modifier -25 and -57 every time
- Boost preventive services reimbursement with modifier secrets Medicare doesn't want you to know
- Get paid for more than one services, even when modifiers haven't worked for you before
- Overcome NP/PA E/M claim denials, and get paid for more of the work they provider
- Reduce your denials by more accurately applying HCPCS E/M modifiers
- And so much more...
Also, Deb highlighted modifier -25 (one of the most complex and misused modifiers). What constitutes “Above and Beyond”? When should you use -25 vs. -24. How do incident-to guidelines affect modifier usage? When you should never use modifier -25? And when you need to be sure you are always using it.
IMPORTANT: Modifier -25 is under constant scrutiny by the OIG, Medicare, Medicaid and many other payers. And since so many practices use this modifier incorrectly, this section of the talk will be worth it on its own.
Every physician, non-physician practitioner, coder and biller should have an solid understanding of E/M modifiers they use to get paid correctly the first time. E/M modifiers are designed to unlock reimbursement, to more accurately pay you for the services your providers perform, but only if you use them correctly. Don't wait, order this how-to session today.
Meet Your Expert
Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P, CDIP
AHIMA Approved ICD-10 Trainer
Certified Documentation Improvement Practitioner
American Medical Association Coding Author
Ms. Grider is a Senior Manager with Blue with over 32 years of experience in coding, reimbursement, practice management, billing compliance, accounts receivable, revenue cycle management, and compliance across many specialties. Her specific areas of expertise include medical documentation reviews, accounts receivable analysis and coding and billing education.
Her background includes many years of practical experience in reimbursement issues, procedural and diagnostic coding, and medical practice management. Deborah consults with private practices, physician networks, health plans, and hospitals assisting with revenue cycle issues as well as assisting with ICD-10 Implementation Strategies and education. She assisted with development of a Medical Assisting Program for Methodist Hospital of Indiana (IU Health) under a federal re-training grant, and developed the Medical Coding Program for Martin University in Indianapolis. She conducts many seminars throughout the year on coding and reimbursement issues. She is the former program director of the Medical Coding Program for Clarian Health Partners (IU Health). Deborah is a legal coding advisor for many attorneys nationally. She has provided testimony for the National Committee on Health Care Vital Statistics on ICD-10 implementation challenges and is considered an ICD-10 expert in the country.
Deborah is a former administrator in a surgical specialty practice in a university setting, and a health care consultant for seventeen years prior to joining Blue as a Senior Manager in Healthcare Revenue Cycle and heads up the ICD-10 consulting team. Deborah has continued to provide consulting and educational services to physicians and hospitals nationally. She also served as the CEO of the American Academy of Professional Coders.
Ms. Grider is the author of many coding publications for the American Medical Association including Principles of ICD-9-CM Coding, Coding with Modifiers and Medical Record Chart Auditor. She is also the author of the ICD-10-CM Implementation Guide, Making the Transition Manageable, Principles of ICD-10-CM and the Principles of ICD-10-CM Workbook. She holds multiple certifications with the American Academy of Professional Coders as well as the CCS-P and CDIP credentials with the American Health Information Management Association. Her professional affiliations include: the American Academy of Professional Coders, the Indianapolis Chapter of the American Academy of Professional Coders of which she was the founder and President from 1996-2003; past President of the American Academy Professional Coders National Advisory Board; member of the American Health Information Management Association, Healthcare Finance Management Association, and the Indiana Medical Group Management Association. Ms. Grider was named one of the Top 10 Health Information Management Professionals in 2009.