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Practices that treat transgender, intersex, and gender-expansive patients take note: Coders should append modifier KX to a claim when a gender-specific procedure or gender-specific diagnosis code doesn’t match the patient’s reported sex
 
Practices that regularly perform facet joint blocks and denervations are bracing for more scrutiny of their claims and challenges to getting paid.
 
 
Just days before it was to take effect, Cigna announced it would “delay implementation” of a strict new policy for E/M services billed with modifier 25 (Significant, separately identifiable E/M service by the same physician on the same date as a procedure).
 
 
It’s not an early April Fool’s joke: CMS won’t issue National Correct Coding Initiative (NCCI) edits in April.
 
Missing: More than 300,000 services that had been reported with 99201 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.)

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