ED Coding and Reimbursement Alert

You will recall from prior Emergency Department Coding & Reimbursement Alert updates that each NCCI edit has a modifier indicator of 0, 1, or 9. Refresh your modifier know-how with this quick list:

• A modifier indicator of 0 indicates that an edit should never be bypassed even if an NCCI-associated modifier is utilized on the claim. That means the column two code of the edit must be denied.
• A modifier indicator of 1 indicates that an edit may be bypassed if an appropriate NCCI-associated modifier is appended to the column one and/or column two code on an NCCI edit. So the column two code of the edit may be paid if an NCCI-associated modifier is appended to an appropriate code of the edit pair.
• A modifier indicator of 9 is assigned as a placeholder for edits that have been deleted.