Becker's Hospital Review

RACs’ Upcoming Part B Audits Likely to Focus on Modifier -25 Usage

When RAC contractors start complex reviews of Medicare Part B claims, they will likely hit practices in a weak spot, physicians’ use of CPT modifier -25, according to a report by the RAC Monitor.
American Academy of Dermatology

OIG report supports dermatologists’ use of modifier 25, CMS requires no further action

In response to the report, CMS concluded that dermatologists are complying with modifier 25 coding rules and the agency will not impose any additional regulations in this area.
Becker's Hospital Review

Does Your Usage of the -25 Modifier Make You a Future RAC Target?

As the RAC contractors ready themselves in the bullpen for their entry into complex review of Part B claims, it is expected that physicians will receive many “blasts from the pasts” as part of the ...
JD Supra

OIG Increases Scrutiny of "Modifier 25"

Medicare payment rules normally do not permit additional payments to physicians for evaluation and management (E/M) services performed on the same day as a therapeutic procedure. However, if the E/M ...
Becker's ASC

When to Use CPT Modifiers 25 & 57

Current procedural terminology modifiers 25 and 57 may be confusing to some coders, but each serves a specific purpose, according to an AAPC report. For an evaluation and management visit when a ...
HealthLeaders Media

Reporting Separately Payable E/M Services with Modifier -25

In general, Medicare considers E/M services provided on the day of a procedure to be part of the work of that procedure. Q: A patient with a history of hypertension and high cholesterol visits a ...