Eli's Rehab Report

Published on Mon May 01, 2000 PDF

Due to errors in comprehensive and component code-pair edits, the Health Care Financing Administration (HCFA) delayed the implementation of the national Correct Coding Initiative (CCI) version 6.1 until May 1. The initial release of version 6.1 contained 3,727 code pairs mistakenly identified with a correct coding modifier of 0 (which signifies that no modifier may be used to unbundle these services) instead of a 1 (which signifies that an appropriate modifier may break the component code from its bundled status).

Version 6.1 also listed 55 code pairs with a 1 modifier instead of a 0. This error potentially could have caused providers to have illegally unbundled these component codes, which could be a red flag for an audit. HCFA expects that all errors will be corrected by May 1.

The National Technical Information Service (NTIS) publishes the CCI edits, along with several other commercial resellers who purchase the raw data from NTIS. According to an NTIS spokesperson, all of their customers, including subscribers and resellers such as Medical Management Institute, Medicode and St. Anthonys, received an errata sheet soon after HCFA made NTIS aware of the errors.

As soon as the errors are corrected, users of any CCI edit products should make sure they have a corrected copy of version 6.1, either in the form of an errata sheet or an updated book. Practices should talk to their insurance carriers to ensure they are using accurate CCI information until version 6.2 is released and implemented on July 1, 2000.