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(Medical Claim) Modifiers: Complying with Payer Variations
Wednesday, February 6, 2013 from 10:00 AM to 11:00 AM (PST)
Palo Alto, CA
This webinar on modifiers used in medical claims w ill explain the hierarchy of guidelines. The session will cover which rules to follow, in which order, and when to challenge an insurer’s modifier coding policy. It will show AMA, Medicare and some Medicaid and private payer modifier coding guidelines and how they vary. Methods to choose the correct modifier will be shown.
Why Should You Attend:
Modifiers are two digits that are used on CPT and HCPCS code lines to tell the insurer a unique story about the service, procedure, or item. Official guidelines and insurer policies on modifier usage often conflict and may shift over time. Using the correct modifier speeds payment processing and avoids denials. Incorrect modifier usage can result in providers having to return payments, pay penalties, and fight fraud allegations.
This session is designed for any compliance director, coder, provider, educator, consultant, or coder, or office manager who is responsible for correct coding and compliance of medical services and procedures. The session will cover correct modifier usage in the primary care practice. The goal is to learn when to apply which modifier guidelines to prevent denials. The strategies also teach proper modifier usage and documentation for improved compliance.
Areas Covered in the Webinar:
- What to do when an insurer’s modifier policy contradicts a CPT® modifier guideline.
- Units vs modifiers: Proper billing methods for multiples.
- Cigna’s therapeutic injection policy.
- Proper usage of modifier 59
- Influenza testing and correct reporting to maximize allowed reimbursement.
- How to tell when to use modifier 52 versus modifier 53
- Global fracture care components.
- Questions to ask before appending modifier 25
- Follow-up fracture care coding options.
- Avoiding global day denials by selecting the correct modifier.
- Steps to take for handling service/procedure bundle denials.
When & Where
At ComplianceOnline, we are focused on :
- Enhancing global compliance, creating a world where quality and compliance professionals, regulators, and government agencies come together to help the world comply with the intent and the spirit of laws, policies and mandates, ensuring continuous improvement in global operations, quality & safety.
- Making sure that we are responsible corporate citizens helping our constituents build a more responsible enterprise, one which operates with high quality , under a code of ethics, and with process discipline to ensure greater shareholder returns.
- Keeping things simple and straight forward , so that we all can indeed improve the quality of our processes, our work, our businesses and enhance compliance globally.
- Being inclusive, giving the process experts ( & novices! ), compliance professionals, quality champions, and regulatory agencies a voice so that all of us can contribute and make a difference.