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After AAP, other organizations protest, Cigna changes course on modifier 25 policy

June 2, 2023

Cigna will delay requiring additional documentation to support the use of modifier 25 when billed with evaluation and management (E/M) Current Procedural Terminology codes 99212-99215 and a minor procedure. The delay follows opposition to the new requirement by the AAP and more than 100 other physician and health care organizations.

This is the second time Cigna has delayed requiring the submission of office notes for E/M services reported with modifier 25. Cigna changed course after the American Medical Association, with support from the AAP and other groups, urged the insurance company to “reconsider this policy due to its negative impact on practice administrative costs.”

Cigna stated that it “will continue to review for future implementation.”

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