tci Medicare Compliance & Reimbursement - 2008 Issue 21

Reader Question: New CCI Verbiage Shouldn't Constrain Your Modifier Use

Version 13.3's introductory notes confused physicians, but we've got clarification Question: In the introduction to Correct Coding Initiative (CCI ) version 13.3 and the subsequent versions (including the most recent, 14.1), it says, "... a significant and separately identifiable E/M service unrelated to the decision to perform the minor surgical procedure is separately reportable with modifier 25." But in some cases, our doctor must perform a service for a related procedure during the same visit. Is the modifier no longer applicable for these services? Answer: The new language has been confusing for quite a few...

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