Wiki NCCI Edits - have some guidance

[CPalmer]

I am trying to find a report listing NCCI edits. I have Googled it and looked on the Medicare website. No luck. I read something that stated it would no longer be available. If I could get a report at least from 2011 that would help out so I have some guidance. Can someone help me, please?

 

[ithomas14]

Here is the link:
https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

At the bottom, choose either physician or hosptial. Hope this helps.

 

[Maryst]

I just need a better version of the edits. It is very time consuming on CMS. I need something telling me the reason for the modifier or which modifier works better.

 

[mitchellde]

That you cannot get, nothing will tell you which modifier and the reason for the modifier is generically that it is a comprehensive edit or a mutually exclusive edit, as far as which modifier then it depends on the scenario and the documentation and it will not always be the same modifier for the same pairing. The only non time consuming way to look up the CCI edits is thru a pay site such as code correct or encoder pro. Both are very good and quick.

 

[ithomas14]

I agree with you. You can't just slap on a modifier to bypass the edit. Whatever modifier you use, you have to have the documentation to back it up. Many edits are there because the codes are considered bundled and will never get paid together. I bought a book called 'Understanding Medicare's NCCI Edits: Logic and Interpretation of the Edits'. You will not get any help with modifiers, but it will explain why there is an edit. Then you can see if your documentation supports a particular modifier. I bought mine used on Amazon.