AHA Coding Clinic® for HCPCS - 2009 Issue 4

NCCI Edits and Separate Procedure Reporting

Many of you are aware that the Central Office on HCPCScannot address any coverage or payment policy issues. As we all are aware, however, coding directly affects payment. The purpose of this article is to help explain (without getting too much into payment) why the National Correct Coding Initiative (NCCI) edits and the Outpatient Code Editor (OCE) were developed and how the NCCI edits and the OCE edits affect how facilities assign HCPCS/CPT codes for procedures and services provided. There are 2 sets of NCCI edits, one set is utilized for hospital reporting and the other set for physician...

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