Consistent misuse and abuse of modifiers is on the Office of the Inspector General's active radar. Meaning they are just waiting for you to slip up.
CMS Transmittal 1422 projected error rates for modifiers over $320 million in physician claims and $450 million in facility claims. Considering the size of these projected overpayments, you can rest assured that CMS is paying close attention and will be working hard to recoup this reimbursement.
So, what does this mean to you? If you are found to be using modifiers erroneously, the reimbursements you received for those services will be taken back. And if that leads to a full scale audit of your modifier claims, you could also have to pay fines for the behavior. Remember, Medicare fines are $10,000 for each occurrence. That means each time you billed a modifier on a claim incorrectly you would have to pay a $10,000 fine.
Your only defense is to take action. You need to get a firm handle on complying with all modifier and national coding expert, Lynn M Anderanin, CPC, CPPM, CPC-I, COSC, CPMA, can show you how during her training session.
Below are just a few of the practical, how-to modifier tactics you'll receive by completing Lynn's training session:
- Modifier -51 vs. -59: Pick the right one and get paid closer to what's deserved
- Properly choose between modifier -25 & -57 every time
- Avoid modifier -59 red flags that will get you audited
- Simple tips to accurately apply the correct modifier for unusual procedural services
- Use modifier -32 for mandated services and watch how it affects your reimbursement
- Get the inside scoop on using modifiers for multiple procedures, and get more services paid
- Boost preventive services reimbursement with modifier secrets Medicare doesn't want you to know
- Reduce denials for global period procedures with -58, -78 and -79
- Identify the most accurate modifier for bilateral procedures (-50 or -RT/-LT)
- And so much more...
You may think that if you don't bill Medicare you don't have to worry about this, but think again. Private insurers are targeting modifier usage too.
And remember, ignorance is not an acceptable defense against fraud violations. If you are targeted for an audit and found to be applying modifiers incorrectly, or if your documentation doesn't back up their use, you could really regret it.
Don't wait, order this information-packed training today.Meet Your Expert:
Lynn Anderanin, CPC, CPPM, CPC-I, COSC, CPMA
Lynn is the Sr. Director of Coding Compliance and Education for Healthcare Information Services, a physician’s billing service. She has 30 years experience in all areas of the physician practice. Lynn has been national conference, workshop, and audio conference presenter and a former member of the AAPC National Advisory Board. She is also the founder of her Local Chapter of AAPC.
“Good presentation with valuable information. Most of it was a refresher for me with good reminders and a few new tips that I will most definitely use.”
“Very helpful training session.”
“We enjoyed the session and the ability to ask questions online.”