Description:

Since medical procedures and services are often complex, it needs to supply additional information when coding. CPT Modifiers provide additional information about the procedure. A modifier may describe a situation's who, what, how, why, or where. Similarly, a CPT modifier may tell whether multiple procedures were performed, why that procedure was necessary, where the procedure was performed on the body, how many surgeons worked on the patient, and other information that may be critical to a claim's status with the insurance payer.

With modifiers playing many essential roles in insurance claims, anyone creating and processing medical claims must understand the modifiers in CPT and HCPCS coding manuals.

Modifiers allow the service provider to explain a more complete picture of the encounter to receive fair and proper reimbursement.

Modifiers tell different kinds of stories and affect the reimbursement of a claim in several different ways. They can cause an increase or decrease in refund, extend a postoperative period, identify an area of the body, or identify extenuating circumstances. Insurance carriers require some modifiers in their policies to label situations for consideration on a particular claim, as well as bring attention to information related to the claim. With modifiers playing so many essential roles in insurance claims, anyone creating and processing medical claims must understand the modifiers found in CPT and HCPCS coding manuals.

Areas Covered:

•  Identify E/M Modifiers.
• Effect of modifiers on claims reimbursement
• Review scenarios in which modifiers are necessary.
• Learn how modifiers affect the postoperative period
• Hear about the reimbursement differences when modifiers are used
• X- modifiers. Are they better than 59?
• Review current documentation to determine changes that need to be made.
• HCPCS modifiers were available.
• Discuss the reimbursement differences when modifiers are used.

Why Should You Attend:

Modifiers are an essential part of claims billing and processing. Modifiers share information with insurance companies that would not otherwise be represented. The misuse of modifiers can mean the difference between payment and denial, as well as applying coding compliance. 

When a simple CPT code isn't enough, it turns to CPT modifiers. These significant additions to CPT codes inform how, where, and why a procedure was performed. This webinar will introduce and explain CPT modifiers and how to use them.

Hence, Modifiers are essential tools in the coding process. "They clarify how things should be paid and further explain or qualify a CPT code."

Who Should Attend:

• Billers
• Coders
• Administrators
• Managers
• Supervisors
• Physician
• Non-Physician providers
• Qualified Healthcare Professionals
• Medical Assistants
• CEO and CFO
• Claims adjusters

Presenter Information:

Name: Lynn M. Anderanin

Lynn Anderanin, CPC, CPB, CPPM, CPMA, CPC-I, COSC, has over 40 years of experience in all areas of the physician practice, specializing in Orthopaedics For AAPC Lynn is currently a VILT Instructor, Workshop, and Audio Presenter. She is the founder of her Local Chapter and a former member of the NAB.

She is the Sr. Director of Coding Compliance and Education for Healthcare Information Services, a physician billing and consulting service in the Chicagoland, area. She has over 30 years of experience in all areas of the physician practice including Practice Administrator, Billing Manager, and Director of Operations. Her experience is primarily in the specialties of Orthopedics, Rheumatology, and Hematology/Oncology.