tci Medicare Compliance & Reimbursement - 2007 Issue 10

CODING: Nix NCCI Edit Headaches With This Override Tip

How to get extra reimbursement for bundled codes.Good news: Under certain circumstances you may override NCCI edits and achieve separate reimbursement for bundled codes.Step 1: Check the correct coding modifier indicator. Each NCCI code-pair edit includes a correct coding modifier indicator of 0 or 1.A "0" indicator means that you may not unbundle the edit combination under any circumstances, according to NCCI guidelines.For example, two new NCCI 12.2 edits have a modifier indicator of 0:• The edit that bundles 93741 (Electronic analysis of pacing cardioverter-defibrillator [includes interrogation, evaluation of pulse generator status, evaluation of...

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