Medicare makes it harder to bypass edits for same side services

Article Overview

This article reviews Medicare’s updated guidance under the National Correct Coding Initiative (CCI) regarding when modifiers may or may not be used to bypass bundling edits for procedures performed on the same side of the body or in adjacent anatomic locations. It is aimed at physicians, coders, and billing staff who need to understand how the policy affects same-encounter procedure reporting and modifier selection. The discussion focuses on broad Medicare coding guidance, paired organs and structures, and examples involving common surgical services.