Difference between revisions of "CCI"

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The National Correct Coding Initiative helps identify codes that should not be billed together by physicians performing the services on the same day.  There are two type of edits that the NCCI includes: Comprehensive Component Edits and Mutually Exclusive Edits.  There is also National Correct Coding Manual that is published on a quarterly basis containing all current data.
 
The National Correct Coding Initiative helps identify codes that should not be billed together by physicians performing the services on the same day.  There are two type of edits that the NCCI includes: Comprehensive Component Edits and Mutually Exclusive Edits.  There is also National Correct Coding Manual that is published on a quarterly basis containing all current data.
  
Edits may include any of the following:
 
  
* 25 modifier edits
+
Dictionaries for the CCI edits are received quarterly, and updated via the Delta process, which are provided by 3M.
* Correct Coding Initiative (NCCI) edits
+
 
* Charge is sex or age inappropriate
+
The CCI flag in the [[Insurance Class]] dictionary needs to be selected in order to utilize the CCI edits.
* Diagnosis is sex or age inappropriate
 
* Free Text Diagnosis Entered
 
* No Linked Diagnosis
 
* Missing Special Billing Information
 
* Missing Charge Amount
 
* No Referring Provider
 
* Missing Start and End Time
 
* Missing Denial Information
 
* Missing Compliance Code
 
* Frequency Limitation
 
* CPT Code Never Covered
 
* Diagnosis Never Covered
 

Latest revision as of 19:06, 1 February 2011

The Centers for Medicare & Medicaid Services implemented the Correct Coding Initiative on Jan. 1, 1996. The purpose of correct coding is to ensure claims are processed accurately following CPT and CMS guidelines. The National Correct Coding Initiative helps identify codes that should not be billed together by physicians performing the services on the same day. There are two type of edits that the NCCI includes: Comprehensive Component Edits and Mutually Exclusive Edits. There is also National Correct Coding Manual that is published on a quarterly basis containing all current data.


Dictionaries for the CCI edits are received quarterly, and updated via the Delta process, which are provided by 3M.

The CCI flag in the Insurance Class dictionary needs to be selected in order to utilize the CCI edits.