March 05, 2018

Quelling the Confusion Over Modifier 25

30 minutes

"Anthem Blue Cross Blue Shield (BCBS) was set to implement a new processing edit with regard to the use of Modifier 25, effective March 1, 2018, but things didn't go as planned," reports Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS), as well as the president of coding and billing services and a partner at DoctorsManagement, LLC. During this episode DeConda explains why Anthem is rescinding the new policy.

The episode rundown also includes:

Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.

IRF Update: Angela Phillips, one of the nation's foremost authorities on inpatient rehabilitation facilities (IRF), reports on Medicare guidelines for an "interrupted stay" in the IRF, and for how services should be billed for these patients.

Medicare Advantage Report: Monitor Mondays national correspondent J. Paul Spencer continues to report on the vexing issue of Medicare Advantage. Spencer is a senior healthcare consultant for DoctorsManagement.

Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron shares another example of a potentially troublesome issue that could pose a risk to your facility.

Whistleblowers: Nationally recognized whistleblower attorney Mary Inman will reports on current whistleblower cases from the London offices of her firm, Constantine Cannon.

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