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Wiki NCCI edits-When viewing

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dovejsd

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When viewing NCCI edits, what does a "9" mean in the modifier column? It states 9 = N/A, but what does that mean?
Thanks.
 
N/A Not Applicable

'9' means that there is no bundling between the two codes. Both codes can be reported without a 59 modifier.

Thanks
 
NCCI edits are created by CMS regarding codes that are bundled. Almost all commercial carriers will also follow NCCI edits (some even implement more). The importance is:
1) to code correctly
2) to obtain proper reimbursement
The information is available through CMS, but not in a particular user friendly format. In the real world, most coders use some type of online encoder to assist with NCCI edits.
med.noridianmedicare.com

National Correct Coding Initiative Edits (NCCI) - JE Part B - Noridian

NCCI edits prevent improper payment when incorrect code combinations are reported for physicians/practitioners and outpatient hospital services.
med.noridianmedicare.com med.noridianmedicare.com
 
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