Tag: E/M service

Modifier 25

Understanding Modifier 25: A Comprehensive Guide

Often, a seemingly routine preventive visit or minor surgery can take an unexpected turn when a patient mentions a new concern, such as “Oh, by the way…” If a physician provides additional care beyond the originally scheduled service, you may be able to bill for a separate evaluation and management (E/M) service using modifier 25. […]
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Bill Minor Procedure

How to Bill an E/M With a Minor Procedure

To determine the appropriate use of modifier 25, review this case study in otolaryngology. The Cigna Group has delayed the requirement for submitting documentation with claims that involve a 25 modified offices or other outpatient evaluation and management (E/M) service (CPT® 99212-99215) and a minor procedure. Despite the payer not enforcing this requirement, physician practices […]
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cigna-updates-modifier-25-reimbursement-policy

Cigna Updates Modifier 25 Reimbursement Policy

Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]
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