rrors Relating to the Billing Process 5. List five of the nine frequent errors r
ID: 139205 • Letter: R
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rrors Relating to the Billing Process 5. List five of the nine frequent errors related to the billing process. 6.4 Strategies for Compliance Carefully Define Packaged Codes and Know Global Periods 1. What do many practices adopt to help decide what is included in a procedure? 2. How can a practice monitor upcoding? 3. List the three modifiers that are especially important for compliant billing. Benchmark the Practice's E/M Codes with National Averages Use Modifiers Appropriately Modifier 25: Significant, Separately Identfiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service 4. When should CPT modifier 25 be used? Modifier 59: Distinct Procedural Service 5. When should CPT modifier 59 be used? 6. What type of information will the new X modifiers provide? s and Compliant BExplanation / Answer
Three modifiers that are especially important for compliant billing are:
Modifier 25 is used to facilitate billing of E/M services on the day of a procedure for which separate payment may be made.
It is used to report a significant, separately identifiable E/M service by the same physician on the day of a procedure.
Modifier 59: “Distinct Procedural Service” – Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day.
Modifier 91 is used to report any repeat clinical diagnostic laboratory test being billed
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