Article

Press Release

AACU on updates to Cigna Modifier 25 policy

Author(s):

As you may know, Cigna recently updated its Modifier 25 – Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service policy to require submission of office notes with all claims including evaluation and management (E/M) Current Procedural Terminology (CPT®) codes 99212, 99213, 99214, and 99215 and modifier 25 when a minor procedure is billed.

The AACU has strong concerns regarding this policy and its associated administrative waste and burdens.

The AACU has strong concerns regarding this policy and its associated administrative waste and burdens.

Cigna will deny payment for E/M services reported with modifier 25 if records documenting a significant and separately identifiable service are not submitted with the claim beginning 5/25/23 or 6/11/23, depending on state.

The AACU has strong concerns regarding this policy and its associated administrative waste and burdens and is working with the AMA federation to request that Cigna rescind its modifier 25 policy and partner with medical organizations on an educational initiative on correct use of the modifier. If you have questions, please contact Kristin Jimison.

Related Videos
Woman having telemedicine appointment with doctor | Image Credit: © Jacob Lund - stock.adobe.com
Stacy Loeb, MD, MSc, PhD (Hon), answers a question during a Zoom video interview
Emily Sopko, CNP, answers a question during a Zoom video interview
Male nurse pushing stretcher gurney bed in hospital corridor with doctors & senior female patient | Image Credit: © spotmatikphoto - stock.adobe.com
Emily Sopko, CNP, answers a question during a Zoom video interview
Stacy Loeb, MD, MSc, PhD (Hon), answers a question during a Zoom virtual interview
Related Content
© 2024 MJH Life Sciences

All rights reserved.