Anthem Blue Cross (Anthem) has identified that providers often bill a duplicate evaluation and management (E&M) service on the same day as a procedure, even when the same provider (or a provider with the same specialty within the same group TIN) recently billed a service or procedure which included an E&M service for the same or similar diagnosis. The use of Modifier 25 to support separate payment of this duplicate service is not consistent with correct coding or Anthem policy on use of Modifier 25. Read the full article.


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Featured In:
May 2019 Anthem Blue Cross Provider Newsletter - California