AACU on updates to Cigna Modifier 25 policy
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.
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.
Experts develop guide on online tools to reduce costs of urologic drugs
April 22nd 2024"At a time when patients are increasingly concerned about prescription drugs, this information will provide a useful starting point for making essential medications as affordable as possible," says Ruchika Talwar, MD.
Qualified charitable distributions and avoiding taxes on RMDs
March 29th 2024"At age 73, you must start taking distributions from the account in the form of required minimum distributions (RMDs), which are typically taxable. This means you must include the RMD in your income and pay income tax on the distributed amount," writes Jeff Witz, CFP.
Potential code for prior authorizations on AMA CPT Editorial Panel meeting agenda
March 28th 2024"Good public and economic policy must align costs, benefits, and incentives; currently, all costs are incurred by physician practices, and all financial savings and benefits from prior authorization accrue to health insurance plans, leading to perverse incentives,” says Alex Shteynshlyuger, MD.
