Modifier Review: Be Sure you are not setting Yourself Up for Audits

Stephanie Thomas, CPC, CANPC, COSC

Stephanie Thomas, CPC, CANPC, COSC

Stephanie has worked in the medical, billing and coding industry for nearly 20 years. It is truly her passion. Stephanie works closely with small and large private practices to audit and collaboratively improve their revenue stream. She prides herself in her dedication to her clients and has built a team of incredible billers and coders to...
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Pre-recorded
60 Mins
Stephanie Thomas, CPC, CANPC, COSC

Modifier use and proper sequencing - CPT and HCPCS

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, expert speaker Stephanie Thomas will discuss modifiers as directed for use with Evaluation and Management services, office-based procedures, surgical procedures, and more!

Stephanie 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. Stephanie 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 it's 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 the 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
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