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Oncology & Hematology Coding Alert

CCI Basics:

Refresh Your Knowledge of How to Legitimately Override Edits

Published on Tue Oct 11, 2011

Don't forget the 'same provider' aspect of CCI-bundled codes.Correct Coding Initiative (CCI) edits are a fact of life for coders, and they come with a rule book all their own. Here's a quick reminder of when CCI says it's OK to report two codes from an edit pair on the same claim.How it works: CCI edits are updated quarterly. They are created for Medicare, but many private payers apply the edits, as well. "All edits consist of code pairs that are arranged in two columns (Column 1 and Column 2)," explains Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, consultant with MJH Consulting in Denver. The general rule is that "codes that are listed in Column 2 are not payable if performed on the same day on the same patient by the same provider as the code listed in Column 1, unless the edits permit the use of a [...]
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