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Internal Medicine Coding Alert

CCI: Modifiers 24 And 57 Will Allow You to Bypass CCI Edits in 2013

- Published on Tue, Dec 18, 2012
Plus: You can also override bundles with modifiers LM and RI We’ve all heard the old coding adage: If the CCI edit indicator is "1," you can separate the bundle using modifier 59 "or another suitable modifier," but many coders have been confused about what other modifiers apply to these instances. CMS now adds to the list of applicable modifiers, with the introduction of four more modifiers that Medicare contactors will accept to bypass CCI edits. Background: When a CCI coding combination is listed as either a mutually exclusive or comprehensive/component edit, the general rule is that both codes cannot be reported separately. However, two CCI indicators are commonly used to indicate when you can, in fact, report the procedures together under circumstances. An indicator of "0" indicates that it is never acceptable to bill these procedures together, and an indicator of "1" indicates that these codes are considered bundled [...]

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