Health Information Management

Pay-per-view: Reduce compliance risk by correctly appending modifier -25 for E/M visits

APCs Insider, December 14, 2012

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Misusing modifier -25 (significant, separately ­identifiable E/M service by the same physician on the same day of the procedure or other service) can be an expensive proposition. Just ask Georgia Cancer Specialists I, a leading oncology practice in Atlanta.

In September, Georgia Cancer Specialists agreed to pay $4.1 million to settle claims it violated the False Claims Act by overusing modifier -25 to bill for E/M services it didn't provide.
Continue reading “Reduce compliance risk by correctly appending ­modifier -25 for E/M visitson HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the December issue.

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