Master New Cigna Modifier 25 Policy to Stop E/M Denials

Length: 60 Minutes Expert: Dreama Sloan-Kelly, MD, CCS, CPC CEU: 1.0
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Cigna will start denying modifier 25 claims in just a few weeks – unless you master their new documentation submission rules. This could easily equate to more than $20,000 a year per provider – money you deserve to be paid.

Once these new requirements are activated, Cigna will deny all office visit claims (99212-99215) with modifier 25 significant, separately identifiable E/M service appended – unless you correctly submit documentation to support the addition of a minor procedure during an office visit.

Just sending documentation with your modifier 25 claims isn’t enough – you must know precisely what to include and what the payer now requires on your cover sheet. It’s time to go on high alert so you can appropriately prepare for this massive billing change. Fortunately, you won’t have to go it alone.

Nationally recognized physician, coder, and healthcare consultant Dreama Sloan-Kelly, MD, CCS, CPC, is here to help. During her one-hour online training session, Dr. Sloan-Kelly will show you EXACTLY what documentation you must submit to Cigna with your claims that append modifier 25. By attending this training, you’ll learn how to avoid the denials Cigna threatens to make.

Here are just a few of the practical strategies Dreama will share during this online training that will help you comply with Cigna’s new documentation submission rule for modifier 25 claims:

  • Pinpoint which E/M codes are affected by Cigna’s new rule
  • Improve your acceptance odds by mastering what must be in your documentation
  • Uncover Cigna’s preferred submission format to avoid having to resubmit notes a second time
  • Evaluate what Cigna considers a “minor procedure”
  • Ace the details that you must include in your cover sheet to boost your acceptance odds
  • Bulletproof your documentation by mastering what “separately identifiable” really means
  • Incorporate these details into your medical records to clearly identify the separate E/M service
  • Master NCCI edits to more easily recognize what and when documentation is submitted
  • Determine how to successfully appeal when your modifier 25 claims are denied
  • And much, much more…

Your only option to collect every penny you’re due from Cigna for modifier 25 claims is to master these new documentation submission rules. If not, you can expect all of your claims containing separately identifiable E/M services to be denied by Cigna. If this happens, you will have provided these services for free. But it doesn’t have to be this way.

By attending this exclusive online training, you can make sure your modifier 25 claims are reimbursed swiftly and accurately. Don’t allow your E/M services to be underpaid when your providers clearly performed these reimbursable services. Sign up for this online training today.

Meet Your Expert

Dreama Sloan-Kelly
MD, CCS, CPCCEO of Kelly, Sloan and Associates, LLC

Dreama has over 14 years of experience in the medical field. A graduate of Wellesley College and Tufts University School of Medicine she has a varied background including clinical, billing, and coding. As CEO of Dr. Sloan-Kelly Consulting, Dreama speaks at various seminars, imparting her knowledge in an upbeat, matter of fact, manner.

Her goal is to provide attendees with only pertinent information to minimize the nonsense, and make sure everyone has fun at the same time. Dreama works with practices one on one, through coding consulting. She offers in-services seminars that can be held on or off-site. Dreama has learned in most seminars you spend a whole day only getting 20% of what you need, and 80% you leave – she has made it her goal to carve out the 20% that you need and giving you the take home message that will help you and your practice.

 

Reviews

The webinar was very informative. I appreciated that the speaker presented the information, as well as some examples. Dreama made it easy to understand and navigate the upcoming change.
Leigh Stokes
Olive Branch Family Medical Center
The webinar was great, concise and provided complete information. The speaker kept it lively!
Allison Minshew
PBP Nation