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Medical Community Advocacy Prompts Anthem to Fully Rescind Payment Cuts for E&M Codes Billed with Modifier 25

Following reports that Anthem notified physicians in many states that it will begin reducing payments by 50% for evaluation and management (E&M) codes reported with a Current Procedural Terminology (CPT) modifier 25, the medical community intervened to prevent the cuts. In response, Anthem has announced that it will not move forward with its planned payment cuts. Last month, Anthem had originally responded to the medical community’s advocacy by lowering the proposed reduction to 25%.

Clinical Alert: Intraocular Use of Epinephrine to Maintain Mydriasis during Cataract Surgery

Issued on December 13, 2017, by the American Society of Cataract and Refractive Surgery

A recent alteration in the formulation of epinephrine from one of the more common sources of preservative-free epinephrine has contributed to a shortage or impending shortage of this product for ophthalmologists. In January 2017, PAR Pharmaceutical updated and began shipping the new formulation of epinephrine which in addition to containing 0.457 mg of sodium metabisulfite, will also contain 2.25 mg of tartaric acid per ml.

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