tci E/M Coding Alert - 2022 Issue Q2

Modifiers: Use Modifiers Wisely to Demonstrate Separate and Distinct Services

Hint: You can’t use modifier 59 on an E/M service code. If your clinician performs multiple services on the same date of service (DOS), you may append a modifier to demonstrate that the services your clinician performed were separate and distinct. Know which modifier choices will lead to accurate coding. Look to NCCI PTP Edit Pairs Many times, services that are performed together on the same date do not present a problem for claims, and no modifier is needed when they are reported together. Sometimes, however, multiple same-day services need to be unbundled, meaning you need to show...

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