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Gastroenterology Coding Alert

Reader Question:

Use Tips to Decipher Modifiers With CCI

Published on Tue Feb 14, 2012

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? New Jersey SubscriberAnswer: 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), 57 (Decision for surgery) or 59 (Distinct procedural service). These modifiers are of use when a CCI edit is in place to help in overcoming the edit and receive payments as is appropriate for both the claims.Reminder: Although some code pairs are bundled in the CCI edit lists, it [...]
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