Medicare Compliance & Reimbursement - 2012 Issue 42
CCI: CMS: Modifiers 24 And 57 Will Soon Allow You to Bypass CCI Edits
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Article Overview
This article reviews a CMS transmittal that broadens the modifiers Medicare contractors may accept for bypassing certain CCI edits. It is aimed at coders and billing professionals who work with CCI edits, modifier usage, and Medicare reporting guidance, especially in evaluation and management and cardiology contexts. The article provides background on CCI edit indicators, discusses the expanded modifier list, and notes the effective date of the CMS guidance.
Why This Topic Matters
Understanding which modifiers CMS recognizes for bypassing certain CCI edits helps coding staff follow current Medicare guidance and avoid denials or incorrect bundling decisions.
Article Sections
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Background
Introduces CCI edit concepts and the general context for when bundled procedures may be reported under certain circumstances. It also distinguishes the broader categories of modifiers commonly discussed in relation to these edits.
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Help is Here
Summarizes the CMS transmittal and the date on which the guidance becomes effective. It also identifies the general types of modifiers addressed by the update and the specialties or service categories most likely to be affected.
What You Will Learn
- How the article frames CMS guidance related to CCI edit bypass modifiers
- Which general categories of modifiers are discussed in the update
- What kinds of services or specialties are most directly affected by the guidance
- When the CMS transmittal described in the article becomes effective
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Cardiology coding specialists
- Evaluation and management coders
Codes Discussed
Modifiers Discussed
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