CCI edits stay when you report 73560 or 73562 with 73565

Why This Topic Matters

The article matters because it addresses a common denial scenario in knee imaging claims and explains why the edit remained in place. It also highlights how CMS and the carrier referenced in the article viewed the relationship between the reported services and the need for modifier-based reporting.

Article Sections

1. CCI edit background and CMS rationale

   Introduces the Medicare CCI edit and summarizes the policy discussion surrounding the affected knee radiology code pair. It also references CMS and the carrier involved in maintaining the edit.

2. Modifier guidance and reporting scenario

   Describes the general modifier-based approach discussed in the article and presents an orthopedic office example of bilateral knee imaging reporting. It also includes a brief reimbursement context for the services discussed.