NCTracks
Recent Updates to Modifiers
On July 19, the following CPT modifiers were added to NCTracks as an acceptable modifier to use with the NCCI Procedure-to-Procedure (PTP) edits as indicated in the January 2013 Medicaid Bulletin (see link below):
24 -Unrelated evaluation and management service by the same physician during a postoperative period
57 - Decision for surgery
January 2013 Medicaid Bulletin
If a modifier is allowed with a NCCI PTP code pair, these modifiers can now be used, if appropriate. For more information about the National Correct Coding Initiative in Medicaid, see the CMS website. Providers who billed with modifiers 24 or 57 and had claims denied with EOB 49270 – NCCI EDIT or 49280 - NCCI OUTPATIENT HOSPITAL SERVICES EDIT can rebill the claims.
In addition, the January 2015 Medicaid Bulletin included an article about four new PTP-associated "X" modifiers to be used in the place of modifier 59. On August 11, changes were made in NCTracks to accommodate the new "X" modifier combinations. The "X" modifiers may now be used in lieu of modifier 59 when appropriate for dates of service on or after January 1, 2015. Providers who billed with one of these “X” modifiers on these dates of service and had claims denied with EOB 07701 - COMBINATION OF BILLED MODIFIERS IS INVALID. PLEASE REVIEW AND RESUBMIT WITH CORRECT BILLING COMBINATION can rebill the claims.
(This is an update to the May 19 announcement posted on NCTracks.)