Medicare Compliance & Reimbursement - 2012 Issue 26
Clip And Save: Measure Your Modifier 59 Applicability With This Quick Chart
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Article Overview
This article explains how to think through modifier selection when procedures are bundled under NCCI edits. It is aimed at coding professionals who need a quick reference for modifier applicability, common pitfalls, and the general decision process for selecting among modifier options without relying on modifier 59 by default.
Why This Topic Matters
Correct modifier selection affects claim accuracy and compliance when services are separately performed but appear in a bundled edit relationship. The article helps readers understand the general modifier decision workflow that supports better coding review and reduced risk of inappropriate modifier use.
What You Will Learn
- How bundled procedure edits affect modifier consideration
- How to use a quick flowchart to evaluate modifier options
- Why modifier selection should not default to a single fallback choice
- What general issues can lead to common modifier coding errors
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Compliance professionals
Codes Discussed
Modifiers Discussed
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