Modifier-25 Examples

Event Information
Product Format
Prerecorded Event
Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS
60 Minutes
Product Description

Know The Appropriate Use of E/M Modifiers with Expert Elin Kunz

Are you prepared for the increased audit activity of Modifier -25? Some private payers are sending warning letters to providers who bill E/M codes with modifiers significantly more than their peers. Carriers do not pay for an E/M service reported with a procedure having a global fee period without a modifier appended to the E/M service. You’ll agree if you have seen the latest settlements related to Modifier -25.

Increasing claim denials, wasted follow-up time, revenue loss, and OIG investigations are some of the potential consequences of inappropriate use of Modifiers.

Join Elin Baklid-Kunz, MBA, CHC, CPC, CCS, in this 60 minutes webinar where she will provide you insights on how to prevent reduced payments and denials, and how to combat increased government scrutiny. Elin will offer tips on how to be in compliance and ensure correct payment. She’ll also help you understand what to look for when auditing, using actual medical record examples in this 60 minute audio session.

Areas covered in the session:

  • Review of Modifier -25, recent settlements and increased audits
  • Compliance risk with inappropriate use of modifiers
  • Review appropriate use of E/M modifiers
  • Medical record review to determine if modifier 25 is appropriate in addition to minor procedure
  • Best practice to mitigate risk

Presentation snapshots:

  • Compliance Risk & OIG’s Report
    • Compliance Risk
    • Recent Fraud Settlements
    • OIG’s Work Plan & Report
  • E/M Modifiers
    • Global Package vs. E/M Modifiers
    • Modifiers -24 & -57 vs. -25
    • CMS Policy
  • Appropriate Use & Scenario
    • Minor Procedure & E/M Service
    • Preventative Services
    • Immunizations
  • Private Payers & Appeal Resources
    • Private Payer Warning Letters
    • Dispute Resolutions
    • Appeal Resources

Who should attend?

Coding Professionals, Billing Specialist, Practice Managers, HIM Directors, Compliance Officers, Case Managers And, Physicians

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About Our Speaker

Elin Baklid Kunz - Medical Billing Coding Expert


Kunz is a national speaker and published author on topics related to medical practice compliance, coding, reimbursement, chart audits and federal regulations. Her twenty years of healthcare experience includes six years as Director of Physician Services for a large health system, seven years in corporate finance and four years in compliance. She presents workshops for the American Academy of Professional Coders and delivers keynote presentations for Eli Research...   More Info
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