National Correct Coding Initiative (NCCI) Associated Modifier Changes (Additions)

Effective 1/1/2013, additional modifiers shall be added to the list of NCCI-associated modifiers that will allow an edit with modifier indicator of “1” to be bypassed when the modifier is utilized correctly. NCCI edits define when two procedure HCPCS/CPT codes may not be reported together except under special circumstances. A modifier indicator of 1 indicates that an edit may be bypassed if an appropriate NCCI-associated modifier is appended to the column one and/or column two code on an NCCI edit. That is, the column two code of the edit may be paid if an NCCI-associated modifier is appended to an appropriate code of the edit pair. These modifiers are: LM (left main coronary artery), RI (ramus intermedius), 24 (unrelated evaluation and management service by the same physician during a postoperative period) and 57 (decision for surgery).