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Modifier allowed in CCI Edit.

Lilygold Posted Tue 15th of March, 2011 22:38:21 PM

Below the CCI edit field, this phrase appears " Note*: Always use modifier (if allowable) with column 2 code ". Would that always mean it is okay to append a modifier ( specifically 59)to the column 2 code or only when appropriate.

SuperCoder Answered Wed 16th of March, 2011 04:59:28 AM

Modifier 59 only be used when appropriate.

Modifiers may be appended to HCPCS/CPT codes only if the clinical circumstances justify the use of the modifier. A modifier should not be appended to a HCPCS/CPT code solely to bypass an NCCI edit if the clinical circumstances do not justify its use.

Modifier 59 is an important NCCI-associated modifier that is often used incorrectly. For the NCCI its primary purpose is to indicate that two or more procedures [where an edit exists that identifies the fact that one is usually performed as a component of the other] are performed at different anatomic sites or different patient encounters. It should only be used if no other modifier more appropriately describes the relationships of the two or more procedure codes.

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