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Claim denial for NCCI Edits from another group

hduncan

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Hi all!
I have a denial for a NCCI edit, the tricky part is, the code they are pairing it with is from a different group all together. I'm not sure of the situation, as far as if the patient was seen one place and then decided to come to us or what, but either way, did an E/M visit along with fundus photos and referred the patient out to a specialist for a detached retina. The insurance company is denying due to another code for a similar procedure being done by another provider on the same date of service. I can't find anything specific in the NCCI edits that talk about this type of situation and in all my years, this is a first!
Any ideas or thoughts on where I can find this specific information?
Thank you in advance :confused:
 
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