This page addresses follow-up questions and additional information pertinent to our webinar
Ensure Correct Modifier Usage in Coding.

** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.

Q: For NCCI Procedure-to-procedure edits, which HCPCS/CPT code, either the column1 or the column2 code should modifiers 59 or appropriate X{EPSU} be appended?
A: Medicare will allow modifiers 59, XE, XP, XS, or XU on either the column1 or column2 code to bypass the edit. MLN Matters MM11168

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM11168.pdf​

Q: Can NCCI PTP-associated modifiers be utilized to bypass all column1/column2 PTP edit pairs?
A: No, NCCI PTP-associated modifiers may only be used with code pairs that have a Correct Coding Modifier Indicator (CCMI) of “1”. Codes pairs with a CCMI of “0” cannot be bypassed with an NCCI PTP-associated modifier.

https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-faq-library#modifiers

Q: If multiple modifiers are required on a CPT code, how should they be ordered?
A: Informational or statistical modifiers should be listed after payment modifiers. Payment modifiers include: 22, 26, 50, 51, 52, 53, 54, 55, 58, 62, 66, 78, 79, 80, 81, 82, AA, AD, AS, TC, QK, QW, and QY.

https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00003604

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