CMS NCCI outpatient code editor has changed effective on DOS 7/1/2019 and later. Now when appending an approved modifier, it can be to either CPT code within a code pair, not just the Distinct Procedural Service CPT code. They have also changed the Column header display from 'Code 1 / Code 2' to 'Column 1 / Column 2'. Would like to hear of any concerns with respect to these changes? In light of the NCCI change, would there be a set 'coding standard of usage' for the appending of the modifier 59 within a code pairing (other than E/M services)? If so, what is the basis of the standard?