Letter and Documentation to AMA Regarding Modifier 25
Attached is a letter I wrote to the American Medical Association regarding my concern over the use of Modifier 25 as it relates to Medical Oncology. I have also sent this letter to oncology-related organizations for review and have received supportive feedback. This letter stems from assisting different clients in four categories of CMS audits this year alone. All four audits involved alleged overutilization of the Modifier 25 (by medical oncology physicians) when a patient presents for evaluation on the day of infusion therapy. Each physician utilized modifier 25 correctly, and their clinical records presented detailed and comprehensive clinical documentation. I am asking the AMA to take 5 action steps. Click on the pdf document below for details.