OIG report supported dermatologists’ use of modifier 25, CMS requires no further actions

A recent report by the Office of the Inspector General found that dermatologists are appropriately using modifier 25 the vast majority of the time. The report was compiled in response to scrutiny by CMS of how dermatologists use the modifier. In 90 out of 100 instances sampled, dermatologists are following Medicare requirements, according to the report.

In response to the report, CMS concluded that dermatologists are complying with modifier 25 coding rules and the agency will not impose any additional regulations in this area.

The AADA remains committed to providing members with educational resources to support accurate coding and advocating for the appropriate use of modifier 25, which is frequently scrutinized by payers. This report will help the Academy continue to fight against inappropriate and restrictive policies implemented by private payers nationwide. The AADA urges physicians’ continued vigilance on the proper use of modifier 25 when providing clinical services.

Check out the Academy’s coding resources.