tci Part B Insider - 2012 Issue 7

Reader Question: Modifier 59 Isn't the Only Answer to Bundling Issues

Question: What advice can you offer for finding a particular code-pair when I am checking through CCI edits? How do I know which among the two is the column-1 code and the column-2 code? Answer: If you are not finding the code-pair in the Correct Coding Initiative (CCI) edit lists, then it can be assumed that the two codes are not bundled. In such a scenario, you will not require the use of a CCI modifier like 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service)...

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