On-Demand: Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Total Runtime: 1 hour and 36 minutes

Appending modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service) to an Evaluation and Management (E/M) code, when also billing a minor procedure on the same day, typically results in payment for both services – the reward. But is it correct?

Payors, including the Office of the Inspector General (OIG), have been auditing the proper use of modifier 25 and recouping millions of dollars from otolaryngologists – the ramification. A common misconception is that the E/M code and procedure code are always billed together. That’s just not true. There are times when it is not appropriate to also report the E/M code but bill only the procedure.

We will examine the CPT guidelines about using modifier 25 as well as what Medicare says. Several scenarios frequently encountered in otolaryngology practices will be reviewed. You will have a better understanding of how to correctly use modifier 25 when performed with the common ENT minor procedures including:

Nasal endoscopy
Flexible laryngoscopy
Endoscopic sinus debridement
Excision of skin lesion, and
Cerumen removal

**Note: CEU credits expire on 4/30/24 for this course.

Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Includes Credits

Component	Credit Type	State/Medical Type	Available Credits	Earned Credits
CEU Certificate	Medical	CEU	1.50	0.00

Recorded On: 04/12/2023

$199 | Appending modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service) to an Evaluation and Management (E/M) code, when also billing a minor procedure on the same day, typically results in payment for both services – the reward. But is it correct?

Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Total: $199

Learning Objectives

We will review:

CPT and Medicare guidelines for applying Modifier 25.
Real scenarios frequently encountered in otolaryngology practices.
When it is and is not appropriate to bill E/M and procedure codes.

You will gain a better understanding of how to correctly use Modifier 25 with common ENT minor procedures including:

Nasal endoscopy
Flexible laryngoscopy
Endoscopic sinus debridement
Excision of skin lesion
Cerumen removal

Reminder: You have 30 days to complete the course from the day you open and access the course.

**Note: CEU credits expire on 4/30/24 for this course.

Deborah Grider, CDIP, CCS-P, CPC, CPC-I, CPC-P, COC, CEMC, CPMA.

Consultant and Speaker

KZA

Deborah is a nationally sought after leader in the industry and is passionate about assisting physicians and hospitals in improving their coding, documentation, and business operations to maintain compliance and improve revenue. She will go above and beyond to help industry leaders, physicians and others achieve excellence. Her motto is “documentation excellence is the key to improving revenue.”

Registering Multiple Attendees

Create, or have each attendee create, a user account here.
1. If one person is creating all of the accounts you will need to log out each time to create the next account.
Log in with the account that you wish to pay through and add desired products to your cart.
Once you have selected all the desired products, go to your cart.
1. You will initially be registered for each product. You can edit this after you have added the additional attendees using the "remove" button.
To add the additional attendees select the green button in your cart titled “Add a Registration for Another User.”
Enter the email address for the additional attendee. If they have an account their name will populate and you can select “Add Product for This User.”
The attendee's name will appear in the registrant column under your own.
Repeat this for each additional attendee.
Proceed, filling out the additional information for each attendee and completing payment.

If you have any issues with completing your registration please email us at education@karenzupko.com or call 312 642-8310

On-Demand: Transfer and Cancellation Policy

All cancellation and transfer requests must be submitted in writing via email to education@kzanow.com. Refunds are subject to an administrative fee per registrant per course according to the following schedule:

The course has not been started.
If there is a pdf handout or workbook available, $60 will be deducted from the refund.
If a hard copy book has been printed/shipped, $60 plus shipping and handling will be deducted.
Timing of your request:
- Cancellation requests must be received via email within 24 hours of purchase for a full refund less above fees.
- Cancellations received after 24 hours of purchase will result in a transfer of funds to another on-demand course within the same year less above fees.

Please email education@kzanow.com to submit your transfer or cancellation request.

On-Demand: Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Using Modifier 25 in Otolaryngology: Rewards and Ramifications

Total: $199

Learning Objectives

Deborah Grider, CDIP, CCS-P, CPC, CPC-I, CPC-P, COC, CEMC, CPMA.

Consultant and Speaker

KZA

Registering Multiple Attendees

On-Demand: Transfer and Cancellation Policy

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