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Home > Audio Learning Center > Using Modifiers to Improve Claim Accuracy

Using Modifiers to Improve Claim Accuracy

Instructor:Jan Hailey, CMC, CMIS, CMOM, CMCO
Schedule: Two 90-minute live webinar sessions on 7/19 and 7/26, 12 noon to 1:30 p.m. Central (10 a.m. Pacific, 1 p.m. Eastern) Set as a Safe Sender in your email server to ensure access to login information.
Target Audience:Coders, billers, practice managers, charge entry and insurance specialists dealing with appeals with at least one year of coding/billing experience
CEUs: PMI certified professionals will earn 3 CEUs. A certificate is sent via email upon completion of the course.
*This Webinar Course is not included as part of the Total Access subscription package. Discount code may be applied.

This course will be recorded and available in PMI’s Online Training Center 2-4 days after the last recording date. Registrants receive access to the session recordings and digital course manual for 6 months following the conclusion of the live course.

Using Modifiers to Improve Claim Accuracy

Documenting the Complete Patient Story  - Updated for 2018

5 Reasons To Attend

How is your confidence level when applying modifiers? An audit letter might make you second-guess yourself.

Don’t lose revenue because of modifier misuse, non-use or just to bypass CCI edits! This class will explain modifiers and when it is appropriate to use a modifier to obtain proper payment.

Class Highlights:

  • Tips for correct use of -X(EPSU) modifiers
  • List and explanation of Levels I and II modifiers
  • E&M modifiers
  • HCPCS modifiers
  • Surgical Modifiers
  • Guidelines and usage tips
  • Negative impacts of modifiers
  • Sharpen knowledge of CPT® guidelines related to modifier usage
  • Why pricing modifiers are considered part of the seven-digit procedure code by CMS
  • Use of modifiers when services are in the global period
  • The difference between modifiers 25 & 59 and modifiers 52 & 53
  • Inclusion of medical necessity in documentation to support the use of modifiers
  • Audit risks and identification of abuse of modifiers as reported by CMS

Who Should Attend

Coders, billers, practice managers, charge entry and insurance specialist dealing with appeals should attend.


At least one year of coding/billing experience for outpatient services is recommended.

What to Bring

Current year CPT and HCPCS manuals are required for this class.

PMI 051518

Continuing Education Units (CEUs)

PMI CEU APPROVED Earn 3 PMI CEUs for attendance at this program. Practice Management Institute grants CEUs for its certified professionals based on total number of instructional hours (1 CEU per hour of classroom instruction). CEUs may be applied to annual recertification requirements, as directed in the certification renewal requirements for your credential(s).

If you are seeking CEU credits for other certifications or organizations, please contact your organization for pre-approval and credit guidelines. A certificate of attendance will be provided.

About the Presenter

Jan Hailey has more than 20 years of experience in health care with proficiency in administration, coding, and billing roles. She joined Saint Joseph Physician Network in South Bend, Indiana as the Director of Quality in November 2015 to lead ambulatory quality initiatives and performance improvement. She works closely with providers, management, and payers to develop strategies on process improvement, gap closures, and patient experience. She leads a comprehensive interdisciplinary team across the health system. Jan also developed a documentation improvement program and is currently implementing an education program for Hierarchical Condition Category (HCC) coding in order to improve risk scores. Jan holds four professional certifications and membership with WPS Medicare's Provider Outreach and Advisory Group, Indiana Association for Healthcare Quality. Jan also serves on Practice Management Institute's National Advisory Board.

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