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Wiki Deleted NCCI edits

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SienTC1720

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We have been questioning the "definition" of deleted in NCCI edits.

We have received a denial from Wellcare for 76856 on the same date as 76830. They did pay 76830. The NCCI table shows the edit was deleted in 2004, so we are a little confused about what deleted really means. With this insurance, it seems they still want the -59 added to the 76856.

Thanks in advance for any insight.
 
Deleted means just that - the edit for the code pair was removed from the NCCI tables as of that date. Medicare and any other payers that strictly follow NCCI would no longer require a modifier for those codes together after the date of service of the deletion. But since not all payers follow NCCI, or may use different versions of NCCI, (or even make errors in loading the tables to their claim system) a deletion doesn't mean that some payers won't continue to require the modifier.
 
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