The medical insurance claim CMS-1500 or the electronic equivalent explain the story of a patient encounter to the insurance carrier. CPT and ICD-10-CM codes show what procedure(s) or service(s) were performed and the reason why those were necessary. The claim paints the picture of the patient’s encounter for that day and the reason why.
Coding and billing is not always black and white as circumstances and situations can occur that change the complexity or reason(s) why procedure(s) or service(s) are performed. Modifier allow the provider of service to explain a more complete picture of the encounter in order 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 reimbursement, extend a post-operative period, identify an area of the body, or identify extenuating circumstances. Some modifiers are required by insurance carriers 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 important roles on insurance claims, it is critical that anyone involved in creating and processing medical claims understand modifiers found in CPT as well as HCPCS coding manuals.
Learning Objectives:-
Areas Covered in the Session:-
Who Should Attend?
Any Organization, Institution or Group User can register
Registration Form support@webinaraxis.comDownload the
Order FormAccess Information for Live Session will be emailed to you 12 hours prior the live date.
Access Information for On-Demand, and Transcript will be emailed to you 24 hours post of the live session.
Also, You can access the training information from your dashboard at WebianarAxis.
Lynn Anderanin, CPC, CPPM, CPC-I, COSC, is the Sr. Director of Coding Compliance and Education for Healthcare Information Services is a Chicago physician billing and consulting service.
