Cigna is delaying and reevaluating a new paperwork demand that was set to go into effect Aug. 13 after receiving pushback from the California Medical Association and American Medical Association.
The now-delayed policy change would require the submission of medical records for all evaluation and management claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed.
In June, the California Medical Association sent a letter to the payer arguing the policy would result in significant, unnecessary administrative burden and compliance cost to physician practices. It would also discourage physicians from providing unscheduled services and create duplicate requests, wasting healthcare dollars, the association said.
The California Medical Association said in a July 12 news release that Cigna is putting the policy under further after the group and American Medical Association contacted the payer about their concerns.
"CMA believes a more collaborative approach to identify alternative methodologies for cost containment — including provider education on proper coding practices that do not bluntly penalize physicians using the modifier appropriately — will prove more effective and less costly in the long term," the group said in the news release.