tci Medicare Compliance & Reimbursement - 2017 Issue 16

Correct Coding Initiative: Some Bundled Procedures Require More than Just NCCI Eligibility

Hint: Know which procedures require modifier 59, too. The National Correct Coding Initiative (NCCI) edits are the last word for most coders on how to determine which procedures are billable together. In most cases, you’d be correct relying on NCCI edits to make sure a particular pair of CPT® codes are appropriately billable. Not so fast: Perhaps the greatest misconception in all of procedural coding, however, is the belief that NCCI edits provide the end-all, be-all determination on CPT® code combinations. On the contrary, there’s more than just an NCCI edit that needs to be taken into...

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