tci Part B Insider - 2008 Issue 29

Modifier Errors: Don't Let Modifier 59 Misuse Take A Bite Out of Your Reimbursement

One carrier reminds practices to heed the rules when using modifier 59 to separate CCI editsTrying to bypass CCI edits? Append modifier 59 to the wrong code and you can kiss your reimbursement goodbye.Medicare payers are taking a new, firmer stance on modifier 59 use. Highmark Medicare, a Part B payer in four states, issued a strongly-worded alert last week reminding you to keep a close eye on those Correct Coding Initiative (CCI) edits.What you already know: Medi-care rules state that you can separate certain CCI bundles by appending a modifier, such as 58 (Staged or...

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