tci Part B Insider - 2012 Issue 42

CCI: CMS: Modifiers 24 And 57 Will Soon Allow You to Bypass CCI Edits

Plus: You can also override bundles with modifiers LM and RI We've all heard the old coding adage: If the CCI edit indicator is "1," you can separate the bundle using modifier 59 "or another suitable modifier," but many coders have been confused about what other modifiers apply to these instances. CMS now adds to the list of applicable modifiers, with the introduction of four more modifiers that Medicare contactors will accept to bypass CCI edits. Background: When a CCI coding combination is listed as either a mutually exclusive or comprehensive/component edit, the general rule is that...

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