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Ophthalmology and Optometry Coding Alert

Reader Question:

Consider Other Sources When CCI Doesn't Provide Info

Published on Tue Jun 07, 2011

Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which code would be considered a column 1 code and which would be considered a column 2 code, so that I could put my modifier on the correct code?Ohio SubscriberAnswer: If the codes are not listed in the CCI edits, the codes are not bundled under the Correct Coding Initiative (CCI) edit pairs. So most likely, you would not need a CCI modifier, such as 59 (Distinct procedural service), to override the edit when warranted.However, a private payer could have a specific coding policy that precludes you from reporting certain codes together even if they aren't bundled according to CCI. You would need to check with a rep for a recommendation. In addition, the CCI Manual (www.cms.gov/NationalCorrectCodInitEd/) and CPT® guidelines may offer broad instructions on types of services that generally should not be [...]
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