Wiki CCI edits help

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shruthi

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Hi all,

I had downloaded the CMS PTP (Procedure to Procedure) coding edits and was just comparing it with AAPC coder and Find-A-Code edits.

I happened to notice that, edit information was differing from CMS PTP edits to that of AAPC Coder/Find-A-Code.

Ex: CPT 71010 and 71021

As per CMS - There is no edits and these can be billed without any modifier. (Modifier status 9)
https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html


As per AAPC Coder - 71010 is a column 2 code for 71021 and requires 59 mod on 71010.

This is just one of the kind and there are many such discrepancies. Anyone has answer as to why the edit information is showing differently.

Regards,
Shruthi.
 
Hello,

If you use code 71010 in column I and 71021 in column II, then edit will show the modifier indicator 9 and this edit was deleted on 01/01/1996 which was mentioned in the deletion date column. Please use the 71021 in column I and 71010 in column II the edit will appear and modifier 59 needed while billed on same date.
 
sivagurulingam said:
Hello,

If you use code 71010 in column I and 71021 in column II, then edit will show the modifier indicator 9 and this edit was deleted on 01/01/1996 which was mentioned in the deletion date column. Please use the 71021 in column I and 71010 in column II the edit will appear and modifier 59 needed while billed on same date.
Click to expand...

Thanks Siva. I had missed to check the deletion date column.

Am planning to develop inbuilt tool to check the edits which can be used across the organisation. I assume that we can take the data base spread sheet from the CMS. Please confirm if anyone has exposure on this.

Regards,
Shruthi.
 
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