How do I change the visible tables in the CPT dashboard?

1. What does the Mue table indicate?
2. What does CCI edits mean?
3. What is a modifier indicator?
4. Can you submit an application to change a CPT code?
5. What does 3 date of service edit clinical mean?
6. What does Mue of 1 mean?
7. What is the purpose of CCI edits?
8. Are CCI edits only for Medicare?
9. How do I check CCI edits?
10. What modifier is needed for 97140?
11. What is the GP modifier?
12. What is the 59 modifier?

What does the Mue table indicate?

An MUE for a HCPCS/CPT code is the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service.

What does CCI edits mean?

National Correct Coding Initiative (CCI) edits are pairs of CPT or HCPCS Level II codes that are not separately payable except under certain circumstances. (CPT codes, which are copyrighted by the AMA in Chicago, are Level I HCPCS codes.)

What is a modifier indicator?

A modifier indicator of “0” indicates that an edit can never be bypassed even if a modifier is used. In other words, the Column 2 code of the edit will be denied. A modifier indicator of “1” indicates that an edit may be bypassed with an appropriate modifier appended to the Column 1 and/or Column 2 code.

Can you submit an application to change a CPT code?

Process for submitting code change applications

All code change applications are to be submitted online via the CPT®️ Smart App. The CPT®️ Smart App platform transforms the application submission process from a paper-based application process to a digital set of tools and resources for proposing code changes.

What does 3 date of service edit clinical mean?

MUEs for HCPCS codes with a MAI of "3" are "per day edits based on clinical benchmarks." MAI 3 indicates it is unlikely additional units of service would appear on a correctly coded claim but could, under unusual circumstances, be payable.

What does Mue of 1 mean?

1. An MUE Adjudication Indicator (MAI) of “1” indicates that the edit is a claim line MUE. a. Appropriate use of NCCI modifiers (e.g., 59, 76, 77, 91, anatomic) may be used to report the same HCPCS/CPT code on separate lines of a claim.

What is the purpose of CCI edits?

The goal of CCI is to eliminate "mutually exclusive" code pairings and codes considered to be components of more comprehensive services or otherwise inappropriate to be delivered to the same patient on the same day. The CCI is updated quarterly.

Are CCI edits only for Medicare?

The NCCI edits are developed for use by the Centers for Medicare & Medicaid Services (CMS) in adjudicating Medicare claims, but they are also used by many private payers and Medicaid agencies.

How do I check CCI edits?

CCI Edits Checker

1. Ability to check CCI edits for up to 25 codes at one time.
2. The codes are automatically sequenced in RVU order regardless of the order you enter the codes into the tool.
3. Quickly reference lay terms, and articles related to the codes entered into the tool.
4. Quickly access the CCI Policy Manual for coding guidance.

What modifier is needed for 97140?

CPT code 97140 is appended with the modifier -59 or the appropriate –X modifier.

What is the GP modifier?

The GP modifier indicates that a physical therapist's services have been provided. It's commonly used in inpatient and outpatient multidisciplinary settings. It's also used for functional limitation reporting (FLR), as physical therapists must report G-codes, severity modifiers, and therapy modifiers.

What is the 59 modifier?

Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.