NCCI Code Pair Edits Need Correction

The Centers for Medicare & Medicaid Services (CMS) has identified nine National Correct Coding Initiative (NCCI) code pair edits that were erroneously included in the integrated outpatient code editor (I/OCE) version 10.0 with an implementation date of Jan. 5.

According to a First Coast Service Options, Inc. report, the following code pair edits should have been marked excluded in the latest I/OCE:

Code pair edits
Modifiers
Column 1
Column 2
Modifier indicator
*90801
90802
0
*90801
96116
0
*90802
96116
0
**96101
96102
1
**96101
96103
1
**96102
96103
1
**96118
96119
1
**96118
96120
1
**96119
96120
1

* Claims with CPT® code combinations listed with a “0” modifier indicator will be held in location S/MSPRD.

** Claims with CPT® code combinations listed with a “1” modifier indicator will be held in location S/MSPRD. However, modifier 59 Distinct procedural service will be added to these code combinations.

Affected claims will be held until successful installation of the April 2009 I/OCE.

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One Response to “NCCI Code Pair Edits Need Correction”

  1. Gabriel Rafael Aponte says:

    Can someone please tell me where can I find the official CMS’ document of this update? I am hitting the “report” link and it does not work.

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