CCI Impact: Check Your Modifier 59 Use in 2015

Why This Topic Matters

The article matters because it addresses a major coding compliance change tied to CCI edits, claim accuracy, and potential payer-specific billing requirements. It helps readers identify the kind of guidance CMS provided and the areas of practice operations that may need adjustment.

Article Sections

1. 59 — The Great CCI Unbundler

   Introduces the article’s discussion of common distinct-service reporting practices and the compliance concerns CMS associated with misuse of modifier 59. It also frames the issue in the context of CCI edits and Medicare guidance.

2. Say Hello to “EPSU” Modifiers

   Summarizes CMS’s move toward more specific modifier options and the policy rationale described in the article. It covers the new modifier family and the broader reporting context without detailing code usage rules.

3. Pick the Best-Fitting Modifier

   Addresses the transition period, payer variation, and the article’s discussion of how CMS expected the new modifiers to be recognized. It also notes the caution around implementation timing and contractor guidance.

4. Anticipate X{EPSU} Impact for Your Practice

   Describes the article’s practice-focused discussion of how the reporting change may affect bundled service claims and reimbursement workflows. It includes the article’s general example of service pairing impact without giving coding instructions.