Coding for Proper Modifier Use in Urology

HEALTHCARE Nov 28, 2017 60 minutes
01:00 PM EST 12:00 PM CST 11:00 AM MST 10:00 AM PST

 Modifiers have been used in urological coding for many years to obtain correct payments for services provided. Recently the office of the Inspector General, OIG, in its review of the use of modifiers have discovered errors in the use of some of the most commonly used modifiers with the result of over payments to urologists and other providers. Because of this, CPT and CMS and their medical agencies have increased their surveillance of the use of all modifiers. New modifiers have been installed to clarify the use of certain codes and procedures and to limit the use of some modifiers. Certain modifiers have been identified for special observation and investigation as to their correct usage.

Attendance at this audio-conference will provide the attendees the necessary information to avoid misuse of specific modifiers and to understand the overall use of modifiers in general. Explanations on how to avoid denials and to ensure proper payments will be made.

   Tips of the Trade: Tips on coding new and old modifiers will be explained with many clinical examples. When modifiers should be used and when they should not be used will be stressed. Criteria for modifier use will be clearly presented.

 Areas covered in the session:

    The following will be discussed:

  • the proper use of modifier-59,
  • the use of the relatively new modifiers X{ESPU} used in place of modifier -59,
  • when and how the new modifiers should be used,
  • the use of modifier-25, a real problem and how to properly use this modifier with E/M services and how to avoid denials when using this modifier,
  • criteria for use of modifiers 24, 57, 58,
  • modifier use when sharing patient surgical care, what modifiers should be used.
  • how to bill for post surgical care within the global period, 
  • how to bill for surgeries and postoperative care given by different unrelated physicians, and
  • much more.

Who should attend? 

Physicians of various specialties, urologists, coders, and billers as well as office staff involved in any way with modifier use will find that this audio conference will increase their modifier understanding.  

 

Presenter BIO

Dr. Michael A. Ferragamo, Jr., MD, FACS is the former chief of urology of Hempstead Medical Center and of Franklin Medical Center of Long Island, New York, and presently is assistant clinical professor of urology, State University of New York, Stony Brook School of Medicine. Dr. Ferragamo is a consulting editor for Urology Coding Alert and is a coding consultant for many private practices across the United States as well as a coding consultant for several academic institutions such as the Lahey Clinic, Burlington, Mass., Intermountain Urology in Utah, NYU Urology in New York City, and Duke Urology, Durham, North Carolina to name a few.

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