Wiki ERCP modifiers

[bbeatty]

When coding multiple ERCPs, do I need a 59 modifier? I thought that I had read somewhere (of course I can't find it now) that for ERCPs a modifier was not necessary. As usual, thanks in advance for your help.

 

[j.berkshire]

It depends on the codes. Most ERCP coding combinations are not bundled by CCI, but check the CCI edits at http://www.cms.gov/NationalCorrectC...r=ascending&itemID=CMS046401&intNumPerPage=10

Here's the ERCP codes from the mutually exclusive coding pairs: if both services are provided, the modifier 59 can be used on the code in the second column.

43268 43267 19960101 * 1
43269 43268 19960101 * 1