Compliance Corner

We are seeing more cases where an organ panel is ordered in the morning that contains an abnormal result. After treatment, the panel is followed up by an order later the same day for only the abnormal component. Our system kicks these out because of correct coding initiative (CCI) conflicts. How should we code these to get them to pass the CCI edits in our system and at Medicare?

These follow-up medically necessary laboratory tests require the use of a modifier to bypass the edits. Since these are CCI edits, the most appropriate modifier is 59 (distinct procedural service).

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