AAPC - Back to school
Results 1 to 3 of 3

Thread: NCCI edits

  1. #1
    Join Date
    Apr 2007
    Spokane, WA

    Question NCCI edits

    AAPC: Back to School
    I have a CPT paring of 62311 (epidural injection into the lumbar spine) and 20552 (trigger point injection, 1-2 muscle groups) being performed on the same day by the same physician.

    When I look up the NCCI edits, it states : 62311 is a component of column 1 code 20552 and cannot be billed using any modifier.

    In this instance, the "component" code has a higher RVU than the column 1 code. Am I required to bill the column 1 code due to the status indicator "0" or can I bill the column 2 code alone so that the physician gets credit for the higher listed RVU procedure? It appears that NCCI is trying to discourage the performance of these two types of procedures on the same day.

    Thanks for your help.

  2. #2


    NCCI Policy Manual for Medicare Services [PDF/ZIP 444KB] - Updated 4/9/09

    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  3. #3


    You may bill one or the other, but not both. When you bill two codes, and one bundles into the other with a modifier indicator of '0' under NCCI, the procedure with the '0' indicator will always deny.

Similar Threads

  1. NCCI edits vs Mutually exclusive edits
    By uhlerclarem in forum Medicare Regulations
    Replies: 1
    Last Post: 10-27-2010, 05:33 PM
  2. NCCI Edits...
    By rryder1963 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 06-07-2009, 06:31 AM
  3. NCCI Edits
    By sward in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-07-2009, 11:40 AM
  4. NCCI edits
    By dovejsd in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-24-2009, 09:36 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.