If I cannot find my two code pairs 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?
Judy
If I cannot find my two code pairs 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?
Judy
If the codes are not listed, the codes are not bundled per CCI. You would not need a modifier to override the edit when appropriate.
A private payer could have a black box edit. You would need to check with a rep for a recommendation (Good luck!).
You can also find Medicare’s other allowed modifier’s in the Physician Fee Schedule. Columns Y-AC indicate if modifier 51, 50 etc. apply.
This info is also in Supercoder's fee schedule information (http://www.supercoder.com/coders-toolkit/fee-schedule/). In October, we’ll have this in an easier to read view.
Jen Godreau, CPC, CPEDC
Content Director, Supercoder.com