Modifier Mondays: a KZA Podcast

We’re kicking off our four-part series on Modifier 78 with KZA Coding Expert Christine Banks. In this first episode, Christine lays the foundation by explaining what Modifier 78 is, when it should be used, and why it’s often confused with Modifiers 58 and 79. Learn how unplanned returns to the operating room are handled during the global period, why the global period doesn’t restart, and how prope...

In this Modifier Mondays Spotlight Episode, KZA Coding Expert Christine Banks shines a light on one of the most common causes of denials, downcoding, and audit risk: documentation pitfalls. From vague clinical notes and missing medical necessity to Modifier 25 errors, undocumented imaging guidance, time-based coding mistakes, and copy-forward concerns, Christine shares real-world examples from her...

We wrap up our Modifiers 52 and 53 series with KZA Coding Expert Deb Grider, who dives into the documentation and compliance issues surrounding these modifiers. Learn about common mistakes, audit risks, payer scrutiny, and the key elements that should be included in your procedure notes. Deb also shares practical guidance for internal audits and ensuring your documentation tells the complete story...

In Part 3, KZA Coding Expert Deb Grider tackles one of the most important questions practices have about Modifiers 52 and 53: how do they affect reimbursement? Deb explains how payers typically evaluate reduced and discontinued procedures, why documentation plays a critical role in payment decisions, and what providers should expect when these modifiers are appended to a claim. This episode offers...

In Part 2 of our Modifiers 52 and 53 series, KZA Coding Expert Deb Grider takes us beyond the definitions and into real-world clinical examples. From cardiology and general surgery to ENT and orthopedic procedures, Deb walks through scenarios that demonstrate when each modifier is appropriate and how patient circumstances drive coding decisions. This episode helps bring these often-confused modifi...

We're kicking off our four-part series on Modifiers 52 and 53 with KZA Coding Expert Deb Grider. In this first episode, Deb breaks down the definitions of Reduced Services (Modifier 52) and Discontinued Procedures (Modifier 53), explaining when each modifier should be used and why understanding the distinction is critical for accurate coding and compliance. If you've ever wondered where the line i...

We wrap up our Modifier 93 and 95 series with KZA Coding Expert Deb Grider, who brings it all together with key questions every practice should be asking before billing telehealth services. From verifying modality and CPT eligibility to ensure documentation and place of service align, this episode provides a practical checklist to support accurate, compliant telehealth billing. A must-listen for a...

In part 3 of our Modifier 93 and 95 series, KZA Coding Expert Deb Grider takes us into the complexities of payer policies and real-world scenarios. From Medicare vs. commercial payer differences to behavioral health examples and connectivity challenges mid-visit, deb highlights how quickly telehealth billing can become nuanced. This episode helps you think beyond the basics and navigate payer-spec...

In Part 2, KZA Coding Expert Deb Grider explores what happens when telehealth modifiers are used incorrectly, and how to avoid those mistakes. From mismatched documentation and missing patient consent to incorrect place of service and modifier selection, Deb walks through common audit findings and practical strategies to clean up your telehealth workflows. This episode is packed with real-world in...

We’re kicking off this four-part, two-modifier series with KZA Coding Expert Deb Grider, diving into the fundamentals of Modifiers 93 and 95. In this episode, Deb breaks down the key differences between audio-only and audio-video telehealth services, when each modifier applies, and why getting it right matters more than ever. If telehealth billing still feels a little unclear, this episode lays th...

We wrap up our Modifier 57 series with KZA Coding Expert Michelle DelMonico, who shares what she’s seeing in the payer space right now. From timing requirements and common denial trends to policy nuances across Medicare and commercial payers, this episode provides actionable strategies to stay ahead of payer scrutiny. Learn how to align documentation, timing, and policy expectations to reduce deni...

In Part 3, KZA Coding Expert Michelle DelMonico highlights the most common pitfalls and mistakes with Modifier 57—and how to avoid them. From applying the modifier to the wrong code to confusing it with Modifier 25, this episode offers practical tips, real-world scenarios, and quick checkpoints to help ensure accurate and compliant use. Perfect for both coders and providers, this episode bridges t...

In Part 2 of our Modifier 57 series, KZA Coding Expert Michelle DelMonico dives into the documentation requirements that make—or break—this modifier. From clearly supporting medical necessity to explicitly documenting the decision for surgery, Michelle walks through what payers are looking for and why vague documentation leads to denials. With real-world examples, this episode helps you build clea...

We’re kicking off our four-part series on Modifier 57 with KZA Coding Expert Michelle DelMonico. In this first episode, Michelle breaks down the definition of Modifier 57 (Decision for Surgery), when it applies, and why it’s so often misunderstood. Learn how global periods impact usage, how Modifier 57 differs from Modifier 25, and why capturing the moment of decision-making is critical for compli...

In this Modifier Mondays spotlight episode, we break down Modifier 27: Multiple Outpatient Hospital E/M Encounters on the Same Date. Learn when this facility-only modifier applies, when it doesn’t, and how clear documentation supports accurate billing and reduces denials. With practical examples and quick tips, this episode helps clarify a commonly misunderstood modifier and ensures your team capt...

In the final episode of our Modifier 22 series, KZA Coding Expert Christine Banks breaks down what payers are doing right now when it comes to increased procedural services. From routine denials and manual reviews to appeal strategies and reimbursement realities, Christine shares practical insights on how payers evaluate Modifier 22 claims. This episode helps practices decide when Modifier 22 is w...

In Part 3 of our Modifier 22 series, KZA Coding Expert Christine Banks breaks down the most common pitfalls and mistakes she sees with increased procedural services, and how to avoid them. From vague documentation and routine variations to misusing Modifier 22 when another CPT code is more appropriate, Christine shares clear guidance on what doesn’t qualify and what truly does. This episode is pac...

In Part 2 of our Modifier 22 series, KZA Coding Expert Christine Banks takes us deep into the documentation details that truly make or break this modifier. Christine walks through how to clearly compare a case to the “typical” procedure, document substantial additional work, and justify why no other CPT code better captures the complexity involved. With detailed real-world examples, this episode h...

We’re kicking off our four-part series on Modifier 22 with KZA Coding Expert Christine Banks. In this first episode, Christine lays the foundation by defining Modifier 22 (Increased Procedural Services), explaining when it’s appropriate to use, and why it’s critical to apply it carefully. Learn what truly qualifies as “substantially greater work,” how Modifier 22 differs from routine variations in...

In the final episode of our Modifier 62 series, KZA Coding Expert Christine Banks breaks down what payers are focusing on right now when it comes to co-surgery billing. From heightened scrutiny and audit activity to common denial drivers and documentation expectations, Christine explains why Modifier 62 is considered high risk and how practices can protect themselves. This episode offers practical...

In Part 3 of our Modifier 62 series, KZA Coding Expert Christine Banks breaks down the most common pitfalls and mistakes she sees with co-surgery billing, and how to avoid them. From using Modifier 62 on procedures that don’t allow it, to documentation issues like “we” statements and mismatched claims, Christine shares practical tips to help bridge the gap between clinical intent and coding compli...

In Part 2 of our Modifier 62 series, KZA Coding Expert Christine Banks takes a deeper dive into documentation requirements and the nuances of co-surgery. Christine walks through what each surgeon must document, how operative reports should be structured, and why mirroring CPT codes, diagnoses, and modifiers is critical. She also shares real-world clinical examples that bring Modifier 62 to life an...

We’re kicking off our four-part series on Modifier 62 with KZA Coding Expert Christine Banks. In this first episode, Christine lays the foundation by explaining what Modifier 62 (co-surgery) is, when it’s appropriate to use, and why it’s critical to get it right. Learn how co-surgery differs from assistant-at-surgery, how payer indicators impact use, and the real compliance and financial risks of...

We wrap up our Assistant Modifiers series with KZA Coding Expert Christine Banks, who shares what she’s seeing in the payer space right now. Learn about common denial trends, medical necessity challenges, utilization monitoring, and appeal strategies. Christine also offers practical guidance on how to proactively strengthen documentation and respond effectively to payer scrutiny.

In Part 3, KZA Coding Expert Christine Banks highlights the most common pitfalls she sees with assistant modifiers—and how to avoid them. From over- and under-utilization to incorrect modifier selection and missing documentation, Christine shares actionable tips, best practices, and documentation strategies to help practices reduce audit risk and stay compliant.