tci General Surgery Coding Alert - 2001 Issue 3

HCFA Suspends a Portion of 6.3 CCI Edits: Proper Use of Modifier -25 Remains Crucial for Receiving Optimal Reimbursement

In a memorandum released Feb. 8, 2001, (B-01-09, Change Request 1546) HCFA announced the suspension of edits that bundled 66 evaluation and management (E/M) codes with more than 800 diagnostic tests and other services listed in the Medicare fee schedule as having XXX global days. The edits were originally introduced in version 6.3 of the national Correct Coding Initiative (CCI). When HCFA first announced its intention to bundle E/M services with diagnostic tests in the November 1999 Federal Register, the agency stipulated that significant and separately identifiable E/M services would be payable if modifier -25 (significant, separately identifiable...

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