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What do modifiers 25, 57 and 59 have in common? Yes, they do all contain the number five. But they also could trigger a prepayment review by Anthem BlueCross BlueShield plans as early as Sept. 1.
Heads up if your practice reports consults to UnitedHealthcare’s commercial policy: the payer will start to phase out coverage of codes 99241-99255 on June 1.
The start date for Medicare administrative contractors (MACs) to expand coverage terms for patients in need of an implantable cardiac defibrillator (ICD) has been delayed a month, CMS said in a Feb. 26 policy update.
Longtime watchers of Medicare’s Correct Coding Initiative (CCI) were shocked to see a note recently on the CMS website that Medicare’s long-time CCI contractor, Carmel, Ind.-based Correct Coding Solutions LLC, is taking itself out of the claims-processing software business after 23 years.

A description that is short but not too simple is the challenge posed by claims with unlisted or not otherwise classified codes.


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