Question NCCI edit, E/M and inj

jsz123

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Hi fellow facility ED coders, my question relates to use of a modifier to clear a CCI edit...... 99283 and 96374: code 96374 is a column 2 code for 99283, but you may use a CCI-associated modifier to override the edit under appropriate circumstances.

I am thinking that the modifier goes on the column 2 code (96374) but not 100% sure. Getting conflicting info with my current sources, so any guidance is appreciated :0)

~ Jen
 

Worxs43

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Hello JSZ123,
You'll need a modifier 25 for the 99283 otherwise the administration code-96374 will bundle/considered inclusive.
 

suchang78

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Hi fellow facility ED coders, my question relates to use of a modifier to clear a CCI edit...... 99283 and 96374: code 96374 is a column 2 code for 99283, but you may use a CCI-associated modifier to override the edit under appropriate circumstances.

I am thinking that the modifier goes on the column 2 code (96374) but not 100% sure. Getting conflicting info with my current sources, so any guidance is appreciated :0)

~ Jen
When they provide IVPB, IVP, IM, infusion, and other procedures (foley catheter, close reduction, splints, suture laceration, etc.). Your EM level always assign with mod " 25 ".
 

suchang78

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New to edits. Does the modifier always go on the Column 1 codes?
Sorry. I can't provide an answer to you because I only assign EM level, infusion, ICD-10-cm, and CPT procedures for the hospital, and billing department takes care of it for us.
 
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