Health Information Management

Pay-per-view: Identify modifier misuse with case studies

APCs Insider, July 25, 2014

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Adding modifiers to CPT® codes can bypass NCCI edits for Medicare payments, but they're often misapplied.
 
NCCI edits are triggered to prevent improper payments when code pairs that should not be reported together are used.
 
One frequently misused modifier is -59 (distinct procedural service), which is appended to identify services or procedures that are not normally reported together, but are appropriate under the circumstances.
 
Continue reading Identify modifier misuse with case studies on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the July issue.



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