2018 Modifier Update: Guidance and Regulations for Hospitals - On-Demand

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2018 Modifier Update: Guidance and Regulations for Hospitals - On-Demand

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2018 Modifier Update: Guidance and Regulations for Hospitals - On-Demand

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Available ON-DEMAND

Presented on:
Thursday, May 10, 2018

Presented by:
Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS
Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, CPAR, CPC, COC

Level of Program:

Sponsored by:

Hospital coders and billers are constantly faced with modifier reporting challenges. They not only have to address issues with long-standing modifiers, but must also familiarize themselves with numerous new details due to 2018 updates to the NCCI and CPT® manuals, new CMS guidance, and recent regulatory updates. Revenue cycle departments must determine when and how to report these modifiers, which frequently have a payment impact. Developing a process for reporting these modifiers can ease administrative burden and reduce the risk of claim denials.

During this 90-minute on-demand webinar, Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, and Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, CPAR, CPC, COC, will review the proper application of modifiers such as -25, -33, -CA, and -FX, as well as those required for identifying drugs, such as -JW. The presentation will include instructions for applying updated regulations and guidance, tips for reporting, and case scenarios for the most challenging modifiers. The presenters will also discuss billing requirements and how modifiers are affected by 2018 updates to the NCCI Manual and the CPT Manual.

At the conclusion of this program, participants will be able to: 

  • Appropriately apply modifiers for E/M and screening services
  • Determine when and how to report inpatient-only modifier -CA
  • Describe proper documentation and billing of drug waste modifier -JW and know where to locate guidance on modifiers -JG and -TB
  • Apply laterality modifiers -50, -LT, and -RT
  • Explain payment reductions associated with the reporting of modifiers -CT, -FX, and -FY
  • Describe some of the latest NCCI and CPT coding guidance for modifiers

Who Should Listen?

  • HIM directors and managers
  • Outpatient coding professionals
  • Compliance officers
  • Chargemaster coordinators
  • Revenue cycle managers
  • Revenue integrity professionals
  • Nurses and nursing staff
  • Finance staff
  • Clinical staff


  • 2018 updates to the NCCI Manual for modifiers
    • Chapter-specific updates that could impact modifier reporting
  • E/M and screening service modifiers
    • Clinical scenarios for reporting visit modifiers -25 and -27
    • Proper application of modifier -33 for preventive services and modifiers -PT and -GG for screening exams 
  • Detailed assessment of when to use inpatient-only modifier -CA
    • Examples, exceptions, and a list of applicable base codes
  • Changes to modifiers associated with drugs
    • Review of how and when to report modifier -JW with the least disruption to workflow
    • Brief synopsis of 340B modifiers -JG and -TB
  • Repeat procedure and laterality modifiers
    • Guidance for overriding procedure-to-procedure (PTP) edits and Medically Unlikely Edits (MUE) for modifiers -76 and -77
    • Examples of how to apply modifiers -LT, -RT, and -50
  • Reporting reduced computed tomography and radiology modifiers
    • Impact of regulations in 2018 OPPS final rule
    • Payment reductions associated with reporting modifiers -CT, -FX, and -FY
  • Live Q&A

Continuing Education

American Health Information Management Association (AHIMA) 
(Live + On-Demand) - This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Ability to claim credits for this webinar expire on: 5/9/19

(Live + On-Demand) - This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webinar expire on: 5/9/19

Meet the Speakers

Sarah L. Goodman

Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, is president/CEO and principal consultant for SLG, Inc., of Raleigh, North Carolina. She is a nationally known speaker and author on the charge description master, outpatient facility coding, and billing compliance, and has more than 30 years’ experience in the healthcare industry. Goodman has been actively involved and held leadership roles in several professional organizations on the local, state, and national levels, including the new National Association for Healthcare Revenue Integrity.

Susan E. Garrison

Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, CPAR, CPC, COC, is executive vice president of Healthcare Consulting Services at Med Law Advisors in Atlanta. Garrison has more than 25 years of experience in healthcare management, including documentation, coding, billing, and reimbursement for both outpatient hospital and physician services. She has conducted hundreds of engagements at hospitals across the country to improve hospital and physician compliance and reimbursement. She also worked for Medicare in Georgia for 12 years. Garrison is the executive director of compliance for the Association of Health Care Auditors and Educators, past president of the AAPC’s National Advisory Board, and past chair for the ACMCS.

Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version is also available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.