tci Part B Insider - 2017 Issue 10

Correct Coding Initiative: Keep Abreast of the NCCI Edits for Bundled Surgical Procedures

Modifier 59 often factors into the claims equation. Coders consider the National Correct Coding Initiative (NCCI) edits to be the last word on determining 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, you need to take more than just an NCCI edit into consideration when billing multiple surgical CPT®...

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