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Thread: Er and ncci edits

  1. #1
    Join Date
    Apr 2007

    Talking Er and ncci edits

    AAPC: Back to School
    I would really apprecitate any advice regarding NCCI edits and ER visits.

    According to NCCI, when a minor procedure (0-10 day global) is performed then an E&M is not reportable unless there is a seperate identifiable service. It doesn't necessarly mean you need a seperate diagnosis, however, the presenting problem has to be warranted for an additional E&M. See pg 27 in the 90000 series for NCCI edits. Why would an E&M be coded with a lac repair in ER if that all was done?

    Melissa Freeman, RHIT,CCS-P,CPC

  2. #2


    NGS Medicare Monthly Review November 2008
    Transmittal A-00-40 & A-01-80
    ...may provide some additional information


    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  3. #3
    Join Date
    Apr 2007
    Bangor, Maine


    It shouldn't be...unless it is like you said and there was a separate, identifiable presenting problem to code for. We wouldn't do that here at the hospital that I work for. But we are also CAH and have our own set of rules.

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