Follow the correct edit to promote payment and avoid denial. By Samantha Prince, BSHCM, COC, CPC, CPMA National Correct Coding Initiative (NCCI) edits for Medicare and Medicaid are not the same. If you’re following Medicare edits for Medicaid claims, you may have claims denying inappropriately. That’s missed revenue you could capture by applying the correct ...
In Billing
Dec 30th, 2011
Medicare contractors received updated instructions and specifications in December for the January 2012 Integrated Outpatient Code Editor (IOCE). They’ll use version 13.0 to edit claims paid under the Outpatient Prospective Payment System (OPPS) and non-OPPS for hospital outpatient departments, community mental health centers, and for all non-OPPS providers; and for limited services when provided in...
In Audit
Oct 28th, 2011
The annual updated version of the National Correct Coding Initiative (NCCI) policy manual for Medicare services will be effective Jan. 1, 2012, rather than Oct. 1, 2011. This manual will be posted on the NCCI website on or around Dec. 1, 2011. CMS posts changes to each of its NCCI and Medically Unlikely Edit (MUE) ...
In CMS
Nov 29th, 2010
Checking the National Correct Coding Initiative (NCCI) website regularly for allowable code combinations helps eliminate questions like the following, asked at the Oct. 6 NHIC, Corp. Mental Health Services Virtual Room/Teleconference: “Can CPT 90862 be provided on the same day as individual therapy?” Don’t Ask; Check NCCI was last modified: January 17th, 2015 by admin aapc...
In Billing
Sep 10th, 2010
Independent and provider-based home health agencies (HHAs) will soon need to be more diligent about certain information listed on claims when billing for services provided to Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) has instructed regional home health intermediaries (RHHIs) to implement expanded edits beginning Jan. 1, 2011. HHA Claim Edits Expanded was last mo...