CCI Edits


Best answers
I have a question in regards to CCI edits and comprehensive codes. I have only ever used 3M, which will indicate when you have unbundled a comprehensive code.

I am wondering how other people determine which code is the comprehensive code and which one is bundled into the comprehensive code.

For example, when I coded a hemorrhoidectomy (46260) and a Hemorrhoid ligation (46945), an edit popped up in 3M indicating that both these codes can not be billed together and than 46260 would be bundled into 46945.

When I look these 2 codes up on the Ingenix Revenue Cycle Pro, and if I enter these 2 codes into the CCI Edit, it just indicates that these 2 codes can not be billed together. How do I know which one is bundled in with the other? I am sure there is a way to determine this, I just must be overlooking it.

Anyone who checks edits this way, please let me know how you determine which code is bundled into the other one.
Last edited:


Best answers

In this case, the 2 codes are mutually exclusive which can be verified on the CMS website MUE table. The allowed codes is listed in column 1 with the non- allowed code listed in column 2 and either 1 or 0 (in this case 0) specifying whether a modifier is allowed.