Advocacy & Practice Updates — Clinical Updates

ASRS Advocacy Prompts Cigna to Delays its Onerous Modifier -25 Policy

In April, ASRS worked with other ophthalmic groups to stop Cigna from requiring that office notes be submitted with all claims containing E/am codes and Modifier -25 when a minor procedure is billed. It appears that the outcry from ASRS and multiple specialty groups was heard. This week Cigna's Modifier -25 policy was updated to include a notification banner stating: “Cigna will delay the implementation to require the submission of documentation to support the use of modifier -25 when billed with E/M CPT® codes 99212 – 99215 and a minor procedure. Cigna will continue to review for future implementation.”

Posted May 25, 2023