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NCCI edits

  1. #1
    Spokane, WA
    Question NCCI edits
    Exam Training Packages
    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. Default
    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.

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