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96 board of trustees - 9 recommendations the board of trustees recommends that the following recommendations be adopted and that the remainder of this report be filed: 1. that our american medical association propose amendments to the bankruptcy abuse prevention and consumer protection act of 2003 h.r. 975 ; which would provide further protections, including establishment of a minimum homestead exemption. that our ama develop a strategy for promoting bankruptcy reform that is consistent with our ama's efforts to promote medical liability reform. that a report on actions taken to implement the above recommendations be provided at the 2004 annual meeting. 10. uses and abuses of cpt modifier -25 house action: recommendations adopted as follows and remainder of report filed introduction this board of trustees report is a result of resolution 718 a-03 ; , "reimbursement for evaluation and management visit performed on the same day as a preventive visit, " which was adopted. this resolution called for the cpt editorial panel to look into other means of reporting combination of services e&m visit on the same day as a preventive visit ; that are more definitive and clearly identify additional non-duplicative services which warrant separate reimbursement. at the time, reference committee g heard limited but forceful and persuasive testimony supporting resolution 718. the testimony discussed the need to find a more specific and less ambiguous method of identifying separate e&m services that occur during the same patient encounter as another physician service or procedure. many payers routinely engage in cpt code bundling, which in this instance is the denial of payment for either the e&m services associated with -25 or the procedure performed on the same day. thus, although resolution 718 a03 ; pertains to e&m services on the same day as a preventive medicine service, the broader issue of e&m services performed on the same day as another service or procedure and the non-recognition and denial of modifier -25 needs to be addressed. this board report reviews the definition, guidelines, and coding illustrations that have been developed by the cpt editorial panel for modifier -25. it will review common misinterpretations of modifier -25 and payer abuses. finally, this report discusses what is being done to have payers recognize modifier -25 and the hazards associated with the possible adoption of a new coding method for reporting e&m services in combination with other services and procedures performed on the same day by the same physician. definition and recommended use of cpt modifier -25 the cpt code set incorporates modifiers as an integral part of its structure. the use of modifiers allows cpt codes to be adopted for different situations without unduly expanding the code set or making it overly complex. modifiers provide a means to demonstrate that a service or procedure was altered by specific circumstances but not changed in its definition or code. a very common and typical use of modifiers involves the provision of multiple services on the same day by the same physician. if a physician performs multiple medical procedures or services on the same date, guidelines within the cpt code set indicate how the procedures should be reported. if the multiple services involve an e&m service and a procedure or an e&m service and a preventive medicine service, then the modifier 25 is used. modifier -25 was first published in cpt 1992. it was revised for cpt 1994 to clarify that modifier -25 is not used to report an e&m service that resulted in a decision to perform surgery, which is reported as modifier -57. the descriptor was further revised in cpt 1995 to include the reporting of an e&m service on the same day as a procedure or other service and for use with preventive medicine codes. modifier -25 was further revised in 1999 to include language regarding the need for different diagnoses. december 2003 and best online poker room.

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I. nsc kristen rodriguez castle rock ; : the state competition was last weekend at the pepsi center. eighty kids participated. mark randall, an exnuggets player was there and kyle, the announcer for the nuggets did all the announcing. the committee really appreciates the support this program gets from doug fulton and the nuggets. j. rsc jill nunes highlands ranch metro district ; : stephanie cpra ; and jill have been working with the rockies. they are still waiting to hear about the grant to help out with the costs of running rsc. saturday, august 23rd the state finals competition will be held at coca-cola all star park in lakewood. all state finalists will then be invited to attend the colorado rockies vs. cincinnati reds game that evening at coors field. the next committee meeting will be after the cara meeting in april. all materials will be handed out then. k. fundraising marc rademacher ft. collins ; : marc and brian broomfield ; are still trying to find a site to have the live online poker party. l. financial report bobby warner windsor ; : the 2007 books are still not closed. please send outstanding receipts. m. cpra update matt miller commerce city ; : stephanie reported that scholarship applications are on the website and need to be done on-line. scholarships are awarded for between 0 and , 500. conference is september 23-26 at the marriott in vail. cpra is looking for sessions that form is on the website also. the theme for this years conference is play in 2008. it was also noted that golf has been moved to tuesday morning. day at the capital is tomorrow. n. website marc rademacher ft. collins ; : marc reported that the website is very close to being done the address is carasports . please send any information or links you would like to see on the website to marc. additionally, let him know what you would like to see on the website - it will be linked to cpra and will have links to cara gymnastics, cara track and the rockies and nuggets skills challenges. vii. unfinished business: a. columbine knolls reinstatement: they sent a check to cpra and are reinstated. b. committee chairs and members update: please put your name on the list if you would like to be on committee and Google. Ron mark jane adam dolev dor natan eve many important cards are flashed during a game. Free texas hold em poiker bonus this live online poker accessories poker room is the online world`s only super-advanced 3-d poker accessories poker room with audio and image technology that offers the look and feel of a real live poker room.