tci Medicare Compliance & Reimbursement - 2009 Issue 6

BUNDLING: 3 Code Pairs You May Not Want To Report Together

Here's expert advice on reporting your code combinations correctly. The Correct Coding Initiative (CCI) offers guidance on which codes you shouldn't bill to Medicare together, and which you can report together with modifiers. But there are exceptions to every rule, and Medicare wants to make sure your coding doesn't fit one of these potential exceptions. Medicare carriers routinely review claims to determine whether your physician reported codes together properly  -- meaning that you should only report the most accurate codes, and you shouldn't bill "extra" codes just because CCI allows it. Here are examples of common "unbundling" scenarios...

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