The column 1/column 2 correct coding edit table contains two types of code pair edits. One type contains a column 2 (component) code which is an integral part of the column 1 (comprehensive) code. If two codes of a code pair edit are billed by the same provider for the same beneficiary for the same date of service without an appropriate modifier, the column 1 code, which generally represents the major procedure with greater work relative value units (RVU) of the two codes, is paid. If clinical circumstances justify appending a CCI-associated modifier to the column 2 code of a code pair edit, payment of both codes may be allowed.
In other words, if your 2 code combo has an indicator "1" it means that, when appropriate, they can be billed together with appropriate modifier, ie: 59. The key words are "when appropriate". The modifier will get them paid, however, are they legitimately a distinct procedure? There are a lot of code combos that are inclusive of the other and have an indicator 1. Some codes bundle together thus making it only possible to use the combo when performed on different anatomical sites. In answer to your second question, if there are no CCI edits, no modifier is required to distinguish one from the other. With that said, I have found that many payers still expect a 59 modifier on the lower RVU code.