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Pediatric Coding Alert

Policy Update:

Gather Solid Modifier 25, 59 Info Before Reporting to CIGNA

Published on Wed May 27, 2009

You now have clear-cut policies to apply, including 1 on 96110 pay. Say goodbye to secret black box bundles and hello to transparent CCI edits for one more insurer. Adhere to CCI Edits, CMS Modifier Guidelines Effective April 20, CIGNA will apply CMS National Correct Coding Initiative (NCCI) Incidental and Mutually Exclusive edits, according to the payers March 2009 Network News. The change puts the insurers policy on a level playing field. For years, CIGNA did their own thing, points out Patti DiSpazio, CPC, business manager at Island Coast Pediatrics in Fort Myers, Fla. Following UHCs change, theyre using CCI edits as a barometer. In addition, the payer will adopt many CMS modifier guidelines. Modifier policies being updated are Modifiers 21, 22, 25, 59, 80, 81, 82 and AS, CIGNA says. Follow Up With Notes for Certain Combos Get ready to have your modifier 25 (CCI incidental edits) and modifier [...]
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