ACA opposes provider, patient burdens from Cigna Modifier 25 policy

June 15, 2023

At issue is a new rule, in effect May 25, requiring all providers to submit office notes with all claims including E/M codes 99212, 99213, 99214, and 99215 and modifier 25 when a minor procedure is billed. Cigna has provided no data or rationale to support the change, leading the health care organizations to question its intent and to propose alternative action. As outlined in Current Procedural Terminology (CPT®), modifier 25 enables reporting of a significant, separately identifiable E/M service by the same physician or other health care professional on the same day of a procedure or other service. About the American Chiropractic AssociationThe American Chiropractic Association (ACA) is the largest professional chiropractic organization in the United States. ACA attracts the most principled and accomplished chiropractors, who understand that it takes more to be called an ACA chiropractor.

The source of this news is from Chiropractic Economics