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Ophthalmology and Optometry Coding Alert

Learn CCI Basics -- Or Watch Denials Flood In

Published on Sat Nov 21, 2009

Not overriding when you can means missing billable services. If you don't understand what Correct Coding Initiative (CCI) edits are, how they work, and how they affect your claims, you're risking denials, fraud charges, and lost reimbursement. Check out these top three frequently asked questions -- and expert answers -- to increase your CCI know-how. 1. What Is a CCI Edit? Every three months , the Correct Coding Initiative (CCI) publishes a list of edits, code pairs that Medicare -- and many private payers -- follow when they reimburse physician practices. The CCI edits list pairs of CPT and HCPCS codes that payers may not pay when performed and billed together for the same date of service. Medicare may consider payment for some of the CCI code pairs dependent upon specific clinical circumstances. "All edits consist of code pairs that are arranged in two columns (Column 1 and Column 2)," explains Marvel J. [...]
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