January 29, 2026

Published by RetinUp Podcast

Elizabeth Cifers on Coding Risk, Modifier -25 Enforcement, and the Rise of Pre-Pay Audits

In this episode, RetinUp introduces a new recurring segment, Vitreoretinal View, focused on surgical innovation and next-generation vitrectomy platforms. John breaks down where vitreoretinal surgery is headed, and comments on Alcon’s UNITY VCS system, flow-based vitrectomy, and his expectations for the next wave of surgical innovation.But first, the conversation kicks off with a discussion of drug access and policy, as John and Scott revisit Outlook Therapeutics’ unsuccessful attempt to secure FDA approval for ONS-5010, an ophthalmic formulation of bevacizumab. They explain why continued access to compounded bevacizumab remains critical for affordability and patient choice.In the second half, the hosts sit down with Elizabeth Cifers, one of the country’s leading ophthalmic coding and compliance experts. Elizabeth offers a clear-eyed assessment of Modifier -25 and Modifier -59, why enforcement has intensified, and how CMS’s shift from post-pay recovery to pre-pay, AI-driven audits is fundamentally changing compliance risk for retina practices heading into 2026. (Do you think your practice’s billing and coding staff would find this episode helpful? If so, share it with them—and tell them to send us feedback by emailing us at info@retinup.com.)

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