Wiki NCCI Bundles

[meganrush]

I am a new coder and am having trouble knowing what codes are bundled with what codes. Is there a resource to tell me this information?

 

[dclark7]

This is the link to the CMS NCCI edits (now called PTP edits). http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

 

[meganrush]

Thank you but I don't understand what this is. Isn't there something to tell me what is bundled in a certain code?

 

[Bready]

The information given to you is correct. The CMS website will have CPT codes listed with the corresponding CPT code(s)that are bundled into it and whether or not a modifier is acceptable for use. Some codes are considered mutually exclusive which means that they can never be used together. Surgical codes will have pre-op and post-op global days included in the code that you can find on the CMS fee schedule page. Individual insurance carriers may have their own ideas on what is "bundled" separate from CMS(UHC for example) and unfortunately most times that is a learn as you go process. Appeals with reference to CMS sometimes work in those cases so it is best to familiarize yourself with the CMS website. Good luck.

 

[dclark7]

Here's another link, this will tell you how to use the NCCI edit tools. http://www.cms.gov/Outreach-and-Edu...NProducts/Downloads/How-To-Use-NCCI-Tools.pdf

 

[meganrush]

Thank you guys, I'll look again I just wasn't seeing codes I needed. I am an OBGYN coder.

 

[syllingk]

it is usually searchable. CTRL + f and type in your code in the box and it should jump you to the first instance of that code in the table.