AHA Coding Clinic® for HCPCS - 2022 Issue 2; In This Issue

Discrepancies between coding guidance and edits

The Central Office on HCPCS frequently receives requests for clarification when coding advice conflicts with payment policies, or edits. The role of the Central Office is to provide advice according to the most accurate and correct coding consistent with coding guidelines and does not address reimbursement policies. However, there are times when reporting policies may conflict and correct coding is not clearly defined. For example, when CPT guidelines and/or the coding advice published in CPT Assistant or Coding Clinic for HCPCS indicates two codes are required for a certain procedure and a National Correct Coding Initiative (NCCI) edit exists...

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