Description: Modifiers can make or break the accuracy and reimbursement of a claim. This session, All About Modifiers, dives into the purpose, correct application, and compliance implications of both CPT (Level I) and HCPCS (Level II) modifiers. We will explore why modifiers were developed, how they impact reimbursement, and how incorrect use can trigger denials, audits, or compliance issues. Using real-world case examples, NCCI edits, MUE logic, and payer-specific guidelines, we will walk through when to append a modifier, when not to, and how to clearly support modifier use with documentation. Attendees will leave with greater confidence in applying modifiers correctly to support clean claims, reduce denials, and ensure compliant billing practices.

Learning Objectives:

• Explain the purpose and structure of Level I (CPT) and Level II (HCPCS) modifiers and why they were developed
• Apply appropriate modifiers to common and complex coding scenarios using documentation, NCCI edits, and payer guidelines to determine medical necessity and claim accuracy
• Identify when modifier use is not appropriate and how incorrect application can lead to claim denials, rework, or compliance risk.
• Differentiate between frequently confused modifiers (e.g., 25 vs. 59, 58 vs. 78 vs. 79, XE/XS/XP/XU) and apply best practices to support accurate reimbursement.
  
  

Webinar Publish Date: This was presented as part of the OHIMA 2026 Annual Meeting & Trade Show - March 11, 2026.
Duration: 1 hour

Speaker: Robin Ingalls-Fitzgerald, CCS, CPC, CEMC, CEDC, has more than 35 years of experience in the healthcare industry and has specialized as a certified medical coder for 28 years. She holds credentials with both the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). As Founder, CEO, and President of Medical Management and Reimbursement Specialists (MRS), Robin is recognized as a thought leader in audit solutions and revenue integrity. She spearheaded the development of MRSAuditQ, an innovative coding audit platform, and Revenue Navigator, a denial management and revenue cycle intelligence solution. These tools reflect her commitment to advancing compliance, financial sustainability, and operational excellence for hospitals, practices, and behavioral health organizations.

Click here to register for this webinar!

Cost: $25 Members / $35 Non-Members
1 AHIMA CEU*
Domain: Data Structure, Content and Information Governance

*AHIMA CEUs are also accepted by the AAPC! Check eligibility on the AAPC website.