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Gastroenterology Coding Alert

Check the Modifier Indicator Before Overriding CCI Edits

Published on Fri Mar 26, 2010

Key: Make sure your documentation will stand up to scrutiny before appending 59. In certain clinical circumstances you can override -- not ignore -- Correct Coding Initiative (CCI) edits and receive separate reimbursement for bundled codes. How it works: "All edits consist of code pairs that are arranged in two columns (Column 1 and Column 2),"explains Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, consultant with MJH Consulting in Denver. "Codes that are listed in Column 2 are not payable if performed on the same day on the same patient by the same provider as the code listed in Column 1, unless the edits permit the use of a modifier associated with CCI." Read on to find out when you can and cannot use modifier 59 to override the edits. Check the Fee Schedule for Clues To find out if you can separately bill services your gastroenterologist performed, first check the [...]
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