Overcoming 2021 Outpatient Hospital and Physician Modifier Challenges - On-Demand

Overcoming 2021 Outpatient Hospital and Physician Modifier Challenges - On-Demand

Available ON-DEMAND

Presented on: Wednesday, July 21, 2021 

Presented by: Sarah L. Goodman, MBA, CHCAF, COC, CHRI, CCP, FCS
Robin Linker, CHCRA, CHCA, CHCAS, CPC-I, CCS-P, COC, MCS-P, CPC-P, CHC

Hospital and physician coders and billers are constantly challenged when reporting modifiers. They not only have to address issues with long-standing modifiers, but must also familiarize themselves with updates to NCCI and CPT® reporting guidance. When reported incorrectly, modifiers can misrepresent the work completed by a provider, resulting in potential claim denials and lost revenue. Developing a process for modifier reporting can ease administrative burden and reduce the risk of denials.

During this 90-minute webinar, Sarah L. Goodman, MBA, CHCAF, COC, CHRI, CCP, FCS, and Robin Linker, CHCRA, CHCA, CHCAS, CPC-I, CPC, COC, CPC-P, MCS-P, CHC, will review the proper application of commonly reported E/M and procedural service modifiers. The presentation will include instruction for applying updated regulations and guidance, tips for CPT reporting, and case scenarios for reporting modifiers -25, -51, and -59. It will also cover appropriate application of telehealth CPT modifier -95 and pertinent HCPCS Level II modifiers. Audience members watching live will be able to ask questions during a Q&A session at the end of the presentation.

At the conclusion of this program, participants will be able to:

• Describe NCCI guidance, including PTP edits and MUEs affecting modifier reporting
• Determine when to report CPT modifiers for E/M and procedural services  
• Adhere to CPT guidance for reporting telemedicine modifiers during the COVID-19 public health emergency 

Agenda

• High-level overview of NCCI edits and their impact on modifier reporting
• Column One and Column Two Correct Coding edits table
• Procedure-to-procedure (PTP) edits and Medically Unlikely Edits (MUE) 
• Commonly reported procedural service and anatomic modifiers
  • Examples for applying modifiers -59, -X{EPSU}, and -51
• Appropriate use of modifiers -52/-53 and -73/-74 for discontinued services
• Reporting guidance for visit modifier -25
  • CMS vs. AMA reporting rules
• Updated 2021 guidance for reporting telemedicine modifiers during the COVID-19 public health emergency
  • CPT modifier -95 and pertinent HCPCS Level II modifiers for telehealth visits
• Q&A