Radiology Coding Alert

Question: Which modifiers may be used to override CCI edits?

South Carolina Subscriber

Answer: The Correct Coding Initiative 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.

Four of the 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."