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The NCCI program includes two types of edits: NCCI edits (also known as Procedure to Procedure (PTP) edits) and Medically Unlikely Edits (MUEs) (Units of Service). NCCI PTP edits prevent inappropriate payment of services that should not be reported together.

But generally, add-on codes don't need a modifier to bypass a bundling edit as long as they're billed in addition to the primary code.

Medicare Code Editor (MCE) is a software program used to detect and report errors in coding data while processing inpatient hospital Medicare claims using the International Classification of Diseases, Tenth Edition (ICD-10) codes.

Contributor. Yes you may append modifier 59 to an add on code. ... While it isn't typical to append modifiers on add-on codes you definitely are allowed to do so. If you have encoder or another coding software it will show per CPT what modifiers are allowed.

Like modifier 51, modifier 59 also has payment implications. Modifier 51 impacts the payment amount, and modifier 59 affects whether the service will be paid at all. Modifier 59 is typically used to override National Correct Coding Initiative (NCCI) Edits.

The NCCI edits were developed by the agency in an effort to establish a uniform coding review method among Medicare carriers. They promote correct coding and attempt to control improper payments made by the Medicare program based on inappropriate coding. The edits can also serve to enforce Medicare payment policies.

Generally speaking, we do not need to report modifier -59 on add-on codes.

An add-on code is a HCPCS/CPT code that describes a service always performed in conjunction with the primary service (see CPT definition below). An add-on code is eligible for payment only if it is reported with the appropriate primary procedure performed by the same physician.

9 (Not Applicable) This indicator means that an NCCI edit does not apply to this PTP code pair. The edit for this PTP code pair was deleted retroactive to the implementation date.