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Gastroenterology Coding Alert

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Watch Out: CCI Modifier Is Distinct From Payment Modifier

Published on Thu May 05, 2011

Question: Sometimes I cannot find my two-code pair in the CCI edits. 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? I can't seem to know where to place my modifier properly.Massachusetts SubscriberAnswer: If you cannot find your two-code pair in the list of Correct Coding Initiative (CCI) edits, it means the codes are not bundled. You would not need a CCI modifier, such as 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service), 57 (Decision for surgery), or 59 (Distinct procedural service), to override the edit when appropriate.Not so fast: Just because a code does not have a bundle in CCI does not mean a modifier is out of the picture. While you won't need a CCI modifier to [...]
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