Episodes
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Modifier 66 - Part 4
We wrap up our Modifier 66 series with a closer look at the payer and compliance considerations surrounding team surgery, with content prepared by KZA Coding Expert Deb Grider. Learn why these relatively uncommon claims may receive additional scrutiny, how Medicare evaluates team surgery using…
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Modifier 66 - Part 3
In Part 3 of our Modifier 66 series, we explore common coding mistakes and practical strategies for avoiding them, using content prepared by KZA Coding Expert Deb Grider. From assuming that three surgeons automatically qualify as a surgical team to confusing Modifier 66 with Modifier 62 or...
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Modifier 66 - Part 2
In Part 2 of our Modifier 66 series, we take a deeper dive into the documentation needed to support team surgery, with content prepared by KZA Coding Expert Deb Grider. Learn what the operative record should establish about medical necessity, each surgeon’s specialty, and the distinct work...
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Modifier 66 - Part 1
In Part 1 of our Modifier 66 series, we break down the fundamentals of team surgery using content prepared by KZA Coding Expert Deb Grider. Learn when a highly complex procedure involving three or more surgeons may qualify for Modifier 66, why simply having multiple physicians involved isn’t...
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Modifier 58 - Part 4
We wrap up our Modifier 58 series with KZA Coding Expert Rebecca Mizelle exploring what payers are looking for when reviewing these claims, with content prepared by KZA Coding Expert Christine Banks. Learn why payers often evaluate Modifiers 58, 78, and 79 together, what makes staged procedures…
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Modifier 58 - Part 3
In Part 3 of our Modifier 58 series, KZA Coding Expert Rebecca Mizelle breaks down common mistakes that can turn a seemingly straightforward modifier into a reimbursement or compliance problem, using content prepared by KZA Coding Expert Christine Banks. From incorrectly using Modifier 58 for...
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Modifier 58 - Part 2
In Part 2 of our Modifier 58 series, KZA Coding Expert Rebecca Mizelle takes a deeper dive into the documentation needed to support proper use of this modifier, with content prepared by KZA Coding Expert Christine Banks. Learn how documentation requirements differ depending on whether a procedure...
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Modifier 58 - Part 1
In Part 1 of our Modifier 58 series, KZA Coding Expert Rebecca Mizelle walks us through the fundamentals of this staged or related procedure modifier, using content prepared by KZA Coding Expert Christine Banks. Learn the three distinct circumstances in which Modifier 58 may apply, how it differs...
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Modifier Mondays Spotlight - ABN Modifiers
In this Modifier Mondays Spotlight episode, KZA Coding Expert Rebecca Mizelle breaks down Advance Beneficiary Notices (ABNs) and the modifiers that communicate a patient’s financial responsibility to Medicare. Rebecca reviews when an ABN should be issued, the choices available to beneficiaries…
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Modifier 79 - Part 4
We conclude our Modifier 79 series by exploring what payers are currently scrutinizing when reviewing these claims. KZA Coding Expert Christine Banks discusses Medicare, Medicare Advantage, commercial payer, and workers' compensation expectations, explains the audit triggers she's seeing most...
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Modifier 79 - Part 3
In Part 3 of our Modifier 79 series, Christine Banks explores the most common coding mistakes she encounters during audits, from billing postoperative pain management incorrectly to confusing Modifiers 79, 78, and 24. She also shares practical workflow tips to help practices identify unrelated...
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Modifier 79 - Part 2
Part 2 of our Modifier 79 series takes a deeper dive into the documentation required to support unrelated procedures performed during an active global period. KZA Coding Expert Christine Banks shares practical documentation tips, explains how to distinguish truly unrelated conditions, and walks...
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Modifier 79 - Part 1
In Part 1 of our Modifier 79 series, KZA Coding Expert Christine Banks breaks down the definition and proper use of this often-confused modifier. Learn when Modifier 79 should be used for unrelated procedures performed during a postoperative global period, how it differs from Modifiers 58 and 78,...
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Modifier 78 - Part 4
We wrap up our Modifier 78 series with KZA Coding Expert Christine Banks, who shares what she's seeing in today's payer landscape surrounding unplanned returns to the operating room. From increased audit activity and denial trends to differences between Medicare, Medicare Advantage, commercial...
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Modifier 78 - Part 3
In Part 3 of our Modifier 78 series, KZA Coding Expert Christine Banks breaks down the most common pitfalls and mistakes she sees with unplanned returns to the operating room—and how to avoid them. From confusing Modifiers 58, 78, and 79 to misunderstanding global periods, operative settings, and...
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Modifier 78 - Part 2
In Part 2 of our Modifier 78 series, KZA Coding Expert Christine Banks takes a deeper dive into the documentation requirements that support an unplanned return to the operating room during the global period. Christine explains the four key elements every operative note should include, discusses…
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Modifier 78 - Part 1
We’re kicking off our four-part series on Modifier 78 with KZA Coding Expert Christine Banks. In this first episode, Christine lays the foundation by explaining what Modifier 78 is, when it should be used, and why it’s often confused with Modifiers 58 and 79. Learn how unplanned returns to the...
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Modifier Mondays Spotlight - Documentation Pitfalls
In this Modifier Mondays Spotlight Episode, KZA Coding Expert Christine Banks shines a light on one of the most common causes of denials, downcoding, and audit risk: documentation pitfalls. From vague clinical notes and missing medical necessity to Modifier 25 errors, undocumented imaging…
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Modifiers 52 & 53 - Part 4
We wrap up our Modifiers 52 and 53 series with KZA Coding Expert Deb Grider, who dives into the documentation and compliance issues surrounding these modifiers. Learn about common mistakes, audit risks, payer scrutiny, and the key elements that should be included in your procedure notes. Deb also...
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Modifiers 52 & 53 - Part 3
In Part 3, KZA Coding Expert Deb Grider tackles one of the most important questions practices have about Modifiers 52 and 53: how do they affect reimbursement? Deb explains how payers typically evaluate reduced and discontinued procedures, why documentation plays a critical role in payment...
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Modifiers 52 & 53 - Part 2
In Part 2 of our Modifiers 52 and 53 series, KZA Coding Expert Deb Grider takes us beyond the definitions and into real-world clinical examples. From cardiology and general surgery to ENT and orthopedic procedures, Deb walks through scenarios that demonstrate when each modifier is appropriate and...
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Modifiers 52 & 53 - Part 1
We're kicking off our four-part series on Modifiers 52 and 53 with KZA Coding Expert Deb Grider. In this first episode, Deb breaks down the definitions of Reduced Services (Modifier 52) and Discontinued Procedures (Modifier 53), explaining when each modifier should be used and why understanding…
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Modifiers 93 & 95 - Part 4
We wrap up our Modifier 93 and 95 series with KZA Coding Expert Deb Grider, who brings it all together with key questions every practice should be asking before billing telehealth services. From verifying modality and CPT eligibility to ensure documentation and place of service align, this…
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Modifiers 93 & 95 - Part 3
In part 3 of our Modifier 93 and 95 series, KZA Coding Expert Deb Grider takes us into the complexities of payer policies and real-world scenarios. From Medicare vs. commercial payer differences to behavioral health examples and connectivity challenges mid-visit, deb highlights how quickly...
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Modifiers 93 & 95 - Part 2
In Part 2, KZA Coding Expert Deb Grider explores what happens when telehealth modifiers are used incorrectly, and how to avoid those mistakes. From mismatched documentation and missing patient consent to incorrect place of service and modifier selection, Deb walks through common audit findings…
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Modifiers 93 & 95 - Part 1
We’re kicking off this four-part, two-modifier series with KZA Coding Expert Deb Grider, diving into the fundamentals of Modifiers 93 and 95. In this episode, Deb breaks down the key differences between audio-only and audio-video telehealth services, when each modifier applies, and why getting it...
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Modifier 57 - Part 4
We wrap up our Modifier 57 series with KZA Coding Expert Michelle DelMonico, who shares what she’s seeing in the payer space right now. From timing requirements and common denial trends to policy nuances across Medicare and commercial payers, this episode provides actionable strategies to stay...
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Modifier 57 - Part 3
In Part 3, KZA Coding Expert Michelle DelMonico highlights the most common pitfalls and mistakes with Modifier 57—and how to avoid them. From applying the modifier to the wrong code to confusing it with Modifier 25, this episode offers practical tips, real-world scenarios, and quick checkpoints…
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Modifier 57 - Part 2
In Part 2 of our Modifier 57 series, KZA Coding Expert Michelle DelMonico dives into the documentation requirements that make—or break—this modifier. From clearly supporting medical necessity to explicitly documenting the decision for surgery, Michelle walks through what payers are looking for…
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Modifier 57 - Part 1
We’re kicking off our four-part series on Modifier 57 with KZA Coding Expert Michelle DelMonico. In this first episode, Michelle breaks down the definition of Modifier 57 (Decision for Surgery), when it applies, and why it’s so often misunderstood. Learn how global periods impact usage, how...
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Modifier 27 - Spotlight
In this Modifier Mondays spotlight episode, we break down Modifier 27: Multiple Outpatient Hospital E/M Encounters on the Same Date. Learn when this facility-only modifier applies, when it doesn’t, and how clear documentation supports accurate billing and reduces denials. With practical examples...
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Modifier 22 - Part 4
In the final episode of our Modifier 22 series, KZA Coding Expert Christine Banks breaks down what payers are doing right now when it comes to increased procedural services. From routine denials and manual reviews to appeal strategies and reimbursement realities, Christine shares practical…
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Modifier 22 - Part 3
In Part 3 of our Modifier 22 series, KZA Coding Expert Christine Banks breaks down the most common pitfalls and mistakes she sees with increased procedural services, and how to avoid them. From vague documentation and routine variations to misusing Modifier 22 when another CPT code is more...
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Modifier 22 - Part 2
In Part 2 of our Modifier 22 series, KZA Coding Expert Christine Banks takes us deep into the documentation details that truly make or break this modifier. Christine walks through how to clearly compare a case to the “typical” procedure, document substantial additional work, and justify why no...
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Modifier 22 - Part 1
We’re kicking off our four-part series on Modifier 22 with KZA Coding Expert Christine Banks. In this first episode, Christine lays the foundation by defining Modifier 22 (Increased Procedural Services), explaining when it’s appropriate to use, and why it’s critical to apply it carefully. Learn...
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Modifier 62 - Part 4
In the final episode of our Modifier 62 series, KZA Coding Expert Christine Banks breaks down what payers are focusing on right now when it comes to co-surgery billing. From heightened scrutiny and audit activity to common denial drivers and documentation expectations, Christine explains why...
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Modifier 62 - Part 3
In Part 3 of our Modifier 62 series, KZA Coding Expert Christine Banks breaks down the most common pitfalls and mistakes she sees with co-surgery billing, and how to avoid them. From using Modifier 62 on procedures that don’t allow it, to documentation issues like “we” statements and mismatched...
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Modifier 62 - Part 2
In Part 2 of our Modifier 62 series, KZA Coding Expert Christine Banks takes a deeper dive into documentation requirements and the nuances of co-surgery. Christine walks through what each surgeon must document, how operative reports should be structured, and why mirroring CPT codes, diagnoses…
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Modifier 62 - Part 1
We’re kicking off our four-part series on Modifier 62 with KZA Coding Expert Christine Banks. In this first episode, Christine lays the foundation by explaining what Modifier 62 (co-surgery) is, when it’s appropriate to use, and why it’s critical to get it right. Learn how co-surgery differs from...
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Assistant Surgeon Modifiers - Part 4
We wrap up our Assistant Modifiers series with KZA Coding Expert Christine Banks, who shares what she’s seeing in the payer space right now. Learn about common denial trends, medical necessity challenges, utilization monitoring, and appeal strategies. Christine also offers practical guidance on…
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Assistant Surgeon Modifiers - Part 3
In Part 3, KZA Coding Expert Christine Banks highlights the most common pitfalls she sees with assistant modifiers—and how to avoid them. From over- and under-utilization to incorrect modifier selection and missing documentation, Christine shares actionable tips, best practices, and documentation...
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Assistant Surgeon Modifiers - Part 2
In Part 2 of our Assistant Modifiers series, KZA Coding Expert Christine Banks takes a deep dive into documentation requirements. From understanding assistant surgeon indicators to knowing exactly what must be documented in the operative note, Christine walks through real-world clinical examples...
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Assistant Surgeon Modifiers - Part 1
We’re kicking off our four-part series on the Assistant Modifiers with KZA Coding Expert Christine Banks. In this first episode, Christine lays the groundwork by defining the assistant modifiers (80, 81, 82, and AS), explaining when each one applies, and why correct usage matters more than ever....
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Subset Modifier XU
We wrap up our X-modifier series with KZA Coding Expert Christine Banks for a deep dive into subset Modifier XU - Unusual Non-Overlapping Service. Christine covers key documentation points, highlights common pitfalls, and shares real clinical scenarios to help you understand when XU truly…
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Subset Modifier XP
In this episode, KZA Coding Expert Christine Banks dives into subset Modifier XP - Separate Practitioner. We explore what it means, how to document it properly, and where coders and providers often go wrong. With detailed case examples, Christine helps demystify XP and offers practical strategies...
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Subset Modifier XS
KZA Coding Expert Christine Banks joins us to unpack subset Modifier XS - Separate Structure. We cover everything from the definition and documentation requirements to common missteps and payer scrutiny. Christine walks through clinical examples that clarify when XS is appropriate and how to keep...
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Subset Modifier XE
In this episode, KZA Coding Expert Christine Banks breaks down subset Modifier XE - Separate Encounter. Learn when and how to use XE correctly, what documentation is required, and how to avoid the most common errors and denials. Christine also shares real-world clinical examples to help ensure...
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Modifier 59 - Part 4
We wrap up our Modifier 59 series with KZA Coding Expert Christine Banks, who shares what she’s seeing from payers right now. Hear the latest trends, denials, and payer focus areas around Modifier 59, and learn how to keep your documentation and coding practices a step ahead.
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Modifier 59 - Part 3
In Part 3 of our Modifier 59 series, KZA Coding Expert Christine Banks tackles the most common mistakes she finds in audits. From overuse to missed opportunities, Christine explains how to recognize red flags, tighten up your processes, and reduce audit risk with clear, confident coding for...
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Modifier 59 - Part 2
In Part 2 of our Modifier 59 series, KZA Coding Expert Christine Banks dives deeper into documentation: what to include, how to be specific, and when another modifier may be more appropriate. She also shares real-world examples that show exactly what solid Modifier 59 documentation looks like in...