Oncology & Hematology Coding Alert
Modifier 24 and More Join CCI Override List
Question: Which modifiers may be used to override CCI edits?
Answer: The Correct Coding Initiative (CCI) manual for Medicare services, Chapter 1, Section E, lists the following modifiers as ones you may use to override edits when appropriate:
Anatomic modifiers: E1-E4, FA, F1-F9, TA, T1-T9, LT, RT, LC, LD, RC, LM, RI
Global surgery modifiers: 24, 25, 57, 58, 78, 79
Other modifiers: 27, 59, 91.
The four bolded modifiers are new additions to the list in the manual, with a revision date of Jan. 1, 2013:
LM, Left main coronary artery
RI, Ramus intermedius coronary artery
24, Unrelated evaluation and management service by the same physician during a postoperative period
57, Decision for surgery.
To help you determine whether it’s appropriate to override an edit, the manual advises, "In general these circumstances relate to separate patient encounters, separate anatomic sites or separate specimens."
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Oncology & Hematology Coding Alert
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