A Deep Dive into Payment and Informational Modifiers

Course Description

This educational webinar is intended for Coders, Managers, Providers, as well as beginners and intermediate. Medical billing fraud is a significant challenge in the healthcare industry, leading to substantial financial losses and legal ramifications. Preventing such fraud through internal audits is a critical strategy that helps maintain the integrity of billing processes and ensures compliance with regulations. Internal audits are an essential tool in the proactive detection and prevention of medical billing fraud, helping healthcare organizations maintain financial integrity and trust with patients and payers. By performing regular internal audits, your organization can identify discrepancies and irregularities, ensure compliance and promote accuracy and accountability. 

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Learning Outcomes

• Apply new and revised CPT and HCPCS codes that impact urology coding and reporting. 
• Identify proper modifier use in urology to support correct reimbursement and reduce denials. 
• Understand parenthetical guidelines and instructional notes and how they affect code selection. 
• Navigate specialty-specific urology updates and apply them confidently in daily coding scenarios. 
• Interpret NCCI edits and modifier indicators to support accurate coding combinations. 
• Recognize common modifier errors and reduce billing and compliance risk. 
• Implement workflow improvements that support consistent coding and cleaner claim submission. 
• Support compliance and audit readiness through accuracy, accountability, and proper documentation alignment. 

Areas Covered in the Session

Recommended Participants

• Coders (Beginner, Intermediate and Advanced)
• Medical Billers
• Coding Auditors
• Coding Managers and Supervisors
• Revenue Cycle Teams
• Compliance and Risk Staff
• Providers and Clinical Leaders
• Residents and Fellows
• APPs (NPs and PAs)
• Practice Administrators
• Denials and Appeals Teams
• Charge Entry and Claims Processing Staff

About the Presenter

Edna Maldonado, CPC, ACS-UR, is a Certified Professional Coder (CPC), Board of Medical Specialty Coding & Compliance (ACS-Urology) and AHIMA ICD-10-CM Trainer. Edna R. Maldonado, CPC, is a bilingual health care management professional that has specialized in urology coding, billing and training for over 30 years. Her training skills are unmatched and she has used them to train several coders new to urology to staff AUA’s Coding Hotline. She has also trained and prepared coders for the CPC coding examination. Her leadership extends beyond training, she has also assisted new coders with goal setting and she has mentored several coders who have moved on to higher positions in urology coding.

Ms. Maldonado’s ambition and drive has elevated her to an expert level in the field of urology coding. She holds herself to the highest standards of professionalism and confidence. She is dedicated to representing her organization and herself in a stellar light by always providing superior results. She is currently the Chair for the Practice Administration Work Group (PAWG) for the AUA, serving as Co-Course Director for the two-day annual Coding Seminar held by the AUA. Ms. Maldonado is an AAPC Officer for her Local Chapter, Frederick, MD.

Ms. Maldonado’s career in urology began in 1990 at Florida Urology Partners (formerly known as Town & Country Urology) where she was hired to manage a busy urology practice by the original owner, Servando Sanchez, M.D. During her time there, Ms. Maldonado was an effective leader with creative skills in interpersonal communications, organizational techniques and problem solving that she used to motivate and to cultivate a diverse staff of eleven. Her time there prepared her for a great opportunity to relocate and join a premier urologic association, providing invaluable support to the urologic community-the American Urological Association (AUA).

Since joining the AUA in 2010, Ms. Maldonado has become a respected and renowned expert in the field of urology coding. She has developed a multitude of urology coding training materials and training techniques for teaching urology coding. As a urology coding trainer, Ms. Maldonado has developed, designed and recorded content for urology coding CDs, webinars and virtual training. As an instructor, Ms. Maldonado has been a lead faculty member for urology coding courses including 30 two-day coding seminars, 27 customized coding seminars and over6 conference coding courses.

Additional Information

Snippets From Our Previous Session