Medical Billing Blog

NCCI Publishes Changes to Coding Modifier -59

Posted by Scott Shatzman on Mon, Sep, 08, 2014 @ 10:09 AM

The Medicare National Correct Coding Initiative (NCCI) published Procedure to Procedure edits
that seek to prevent unbundling of services and overpayment. The requirements state that if one code defines a subset of work of another code, the codes should not be reported separately, which would be considered double billing. The notice states that modifier -59 defines a “Distinct Procedural Service” which represents a service that is separate and distinct from another service with which it would usually be considered to be bundled.

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