tci Part B Insider - 2012 Issue 26

Part B Mythbuster: Procedures Are Bundled? In Some Cases You Can Still Bill Them Together

Interpret CCI properly to know when you can report both.When your physician performs two medically necessary procedures during the same session but the Correct Coding Initiative (CCI) bundles the procedures together, you might be inclined to simply write off the bundled portion. However, in some cases, the bundled procedure can be separately billable--if you know when you're allowed to separate CCI edits. A firm knowledge of what constitutes a \"separately identifiable procedure,\" along with the specifics of modifier 59, are essential for your coding.The problem: Modifier 59 (Distinct procedural service) is one of the most misunderstood...

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