Tip: Append modifier to correct code
APCs Weekly Monitor, September 24, 2010
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Each National Correct Coding Edits (NCCI) table contains edits, which are pairs of codes that, in general, should not be reported together.
If a provider reports two codes of an edit pair, the payer will deny the column 2 code and pay the column 1 code. That’s true for the NCCI and Mutually Exclusive Edits tables.
When it’s valid, attach modifier -59 (distinct procedural service) to the applicable column 2 code rather than the column 1 code.
This tip was adapted from "Five myths about correct use of modifier -59 busted" in the September issue of Briefings on APCs.
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Related Products
-
Modifier -59 Case Studies: Clarify Common Coding Confusion
Modifier -59 is a perennial problem area for outpatient coders. It shouldn’t be viewed as a way to guarantee payment but...
-
Outpatient Bed Charge Capture: Billing for Common and Complex Cases
During this 90-minute audio conference, our expert speakers walk you through common and complex cases and explain compliant...
-
Billing No-Cost and Low-Cost Devices: Tips to Avoid the Audit Fast Track
During this 90-minute audio conference, our speakers will use a case study to demonstrate best practices to help you comply...
-
Spinal ICD-9 and CPT Coding
During this two-hour audio conference, our speakers will discuss common coding errors for spinal diagnoses and procedures...
-
2012 OPPS Final Rule: Analyze the Impact and Manage the Changes
Expert speakers Jugna Shah, MPH, and Valerie A. Rinkle, MPA, return for this popular program. They review the final rule...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Topic: CMS, OESS post new security compliance review information, checklist
- HIPAA Q&A: Level of encryption needed for email
- Identify potential Medicaid RAC target areas
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- QA:Coding multiple initial infusions
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Catch up on what's new with injections and infusions
- CMS has reformulated payments for some bilateral procedures
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched