Modifier Review, Be Sure You Are Not Setting Yourself Up for Audits

The use of modifiers can be challenging. Modifiers are used to change the meaning or further describe CPT® codes and could alter the reimbursement for services provided. In this session speaker will discuss modifiers as directed for use with: Evaluation and Management services, office-based procedures, surgical procedures and more! The session will also help attendees build a better understanding of specifically how the modifiers should be utilized. Extra emphasis will be placed on the more confusing modifiers, such as: 25, 51 and 59, 76, 77, 78, and 79, which are commonly misused. Expert speaker Stephanie Thomas will also cover HCPCS Level II modifiers.

Webinar Objectives

• Modifier proper usage in uncertain times with payers. Examples of what NOT to do to “just get the claim paid”.
• How important physician documentation is in selecting appropriate modifiers, and how to collaborate and communicate effectively with providers to suggest addendums, or additional information to add to their records. 
• EOBs are complicated and its difficult sometimes to understand what the REAL issue is with a claim-we will give some tips and tricks on this hot topic as well. 
• Sequencing of modifiers to ensure proper payment and response.

Webinar Agenda

• Prevent denials and claim issues by submission of proper modifiers on first billing.
• Identify specific payer requirements and how to find these for reference. Description and LOTS of examples of hard-to-understand modifiers. 
• How to appropriately rebill if a modifier was changed or added.

Webinar Highlights

• Modifier use and proper sequencing (Both CPT and HCPCS modifiers)
• Denials and how to prevent and address when received. 
• Real world examples (LOTS) to show proper and improper usage.
• How to find payer specific guidelines on modifiers
• Audit documentation and learn to collaborate with providers to improve claim outcomes.

Who Should Attend

• Medical providers
• Managers 
• Billing team
• Front desk
• MA’s
• Pre auth specialists