tci Medicare Compliance & Reimbursement - 2008 Issue 30

Modifier Errors: Save Your Reimbursement By Putting A Stop To Modifier 59 Misuse

Practices to heed the rules when using modifier 59 to separate CCI edits -- or else, carrier warns Trying to bypass CCI edits? Append modifier 59 to the wrong code and you can kiss your reimbursement goodbye. Medicare payers are taking a new, firmer stance on modifier 59 use. Highmark Medicare, a Part B payer in four states, issued a strongly-worded alert last week reminding you to keep a close eye on those Correct Coding Initiative (CCI) edits. What you already know: Medicare rules state that you can separate certain CCI bundles by appending a modifier, such as...

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