Cigna Policy Change for Modifier 25 Delayed


Medical societies to submitted a letter regarding Cigna’s modifier 25 policy change the letter asked CIGNA to immediately redact its policy requiring submission of office notes with all claims that have evaluation and management (E&M) procedure codes 99212, 99213, 99214, and 99215 and modifier 25 when a minor procedure is billed. As of yet there has not been a formal reply from Cigna, there has been information received that Cigna is preparing to announce a delay in implementing the updated modifier 25 policy. Cigna Policy Change states that when billing E&M codes 99212-99215 and a minor procedure that medical notes will be required to support the use of the modifier 25.

The primary reason why Cigna's decision is delayed is to review the reimbursement policy update and its requirements. This initiative allows Cigna to optimize the provider and patient experience and undertake additional provider education in collaboration with key national medical associations. Cigna aims to ensure that modifier 25 is used appropriately and in alignment with all national guidelines and industry standards.

Although a new implementation date has not been stated as of yet, Cigna assures all that they appreciate the partnerships and to please be patient during this process. Cigna looks forward to working more collaboratively with provider partners, medical associations, and their membership to enhance the understanding and utilization of modifier 25.

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