National Correct Coding Initiative (NCCI) edits are used by the Medicare program, state Medicaid programs as well as some commercial insurance carriers and workers compensation carriers to combat abusive and fraudulent billing practices in outpatient therapy as well as other services. Modifier 59 is used by outpatient therapy providers to bypass certain NCCI edits and allow the payment of more than 1 CPT code billed on the same day that an insurance carrier may consider should be bundled and separate payment should not be made. Because of this, modifier 59 is not only the most commonly used modifier, it is also the most commonly abused modifier. In addition, the need to use modifier 59 is not only within the same discipline but may also be required when a patient is receiving multiple disciplines from the same provider on the same date of service.
Version 28.2 is effective with dates of service between July 1 – September 30, 2022. This 1-hour webinar program will explain NCCI edits, the use of modifier 59 and what CPT code(s) to append modifier 59 to on the claim form. In addition, the webinar will provide detailed and realistic examples when providers of outpatient therapy services would utilize modifier 59. Examples will include all 3 disciplines as well as how speech therapy billing impacts the physical and occupational therapy codes billed the same day. The webinar will also provide the latest information on the XE, XP, XS and XU modifiers. Lastly, participants will receive Gawenda Seminars & Consulting NCCI Version 28.2 “cheat sheet” to assist them in knowing when to apply modifier 59 to a CPT code on the claim form.
At the conclusion of this webinar presentation, participants will be able to:
- Describe and understand column 1/column 2 NCCI edits and which CPT code(s) requires modifier 59
- Be able to use the NCCI edit “cheat sheet” to append modifier-59 to the correct CPT code(S) on the claim form
- Recite how one discipline’s billing may cause another discipline’s billing to require modifier 59
- Understand the documentation that must be present in the medical record to support the use of modifier 59
- Summarize the current payment status of a physical or occupational therapy evaluation or reevaluation when billed on the same date of service as an emergency department visit
Physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language pathologists, private practice owners and practice administrators, coders and office managers at private practices, as well as directors, managers, supervisors, compliance officers, risk managers, and billers in skilled nursing facilities, hospital outpatient therapy departments, schools, rehabilitation agencies, home health agencies, and comprehensive outpatient rehabilitation facilities.
In addition to the expertise and advice presented during this webinar conference, you’ll also receive a handout (in PDF format) that will include related reference links as well as Gawenda Seminars & Consulting NCCI Edit Version 28.2 “Cheat Sheet” for use of modifier 59 in outpatient therapy.
Webinar – Computer and internet connection required. Participants will be provided a url link where they can log in and follow the presentation on their computer as the speaker provides the presentation. If your computer has speakers, you will be able to hear the audio portion through your computer speakers and will not require a phone connection. No phone lines will be available for this webinar.
This webinar has not been submitted to any state board or national organization for CEU approval. A certificate of attendance will be available upon completion of the webinar for each participant and may be adequate for credit in some states; you will need to contact your state licensing regulatory body to determine whether or not credit will be granted for this webinar conference. We provide no additional information for CEU approval.
Register for the event on or before 12:45pm EDT on July 6, 2022.
When you register, you’ll receive a confirmation e-mail that serves as your receipt. You will receive an email the day prior to the webinar that will provide you instructions on how to access the webinar, test your computer and download the handouts. If you register the day of the webinar, instructions are emailed every half hour beginning at 10:00am EDT. Please make sure that your email system will accept messages from the webinar conference host: seminars@gawendaseminars.com. The easiest way to do this is to add this email address to the contacts list in your email software.
Gather your staff and listen to this webinar conference via your computer speakers or a speaker phone, follow along with the session handout on your computer, and participate in a live, interactive Question and Answer session.
PLEASE NOTE: ONE REGISTRATION PROVIDES YOU WITH ONE COMPUTER CONNECTION FOR THE WEBINAR CONFERENCE. You may pay for additional locations where indicated on the registration form.
There are no refunds for no shows or any other reasons once you register and payment is received. We are not responsible for organization firewalls or computer software issues that may interfere and/or prohibit your connection to the webinar portion of the presentation.
Playback link is NOT included with registration, but registrants have an option to purchase a playback link for $49.95 prior to completing online registration.
Playback link allows you to view and listen to the webinar live on your computer as many times as you would like and the playback link is emailed 72 business hours after the completion of the webinar.
If you know you will not listen live, you do not need to purchase the playback link for an additional $49.95.
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