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Pathology/Lab Coding Alert

Reader Question:

Distinguish 2 CCI Edit Files

Published on Fri Jan 13, 2012

Question: Our lab performed a calcium test, and later the same day, the physician ordered a calcium infusion test. Medicare denied the second test based on a CCI edit, but I can't find the edit on the CCI edit table. What am I missing?Tennessee SubscriberAnswer: Perhaps you looked for the edit pair on the Correct Coding Initiative (CCI) column 1/column 2 edit table, but you can find the pair on the mutually exclusive table:82310 -- Calcium; total82331 -- ... after calcium infusion test.The column 1/column 2 edit table generally involves procedures in which the code in column 2 is a component of the column 1 code. In contrast, the mutually exclusive table deals with codes that would rarely be performed together because, for instance, they represents two tests for the same analyte using different methodology.Whether the edit pair is on the column 1/column 2 table or the mutually exclusive table, you need [...]
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