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NCCI edits vs Mutually exclusive edits

  1. Default NCCI edits vs Mutually exclusive edits
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    Our Medicare carrier-Palmetto- has two files listed- one as CCI edits (column 1 vs column 2 edits) as well as a file listed as Mutually Exclusive edits. The codes seem to be the same, but in different order-is there any difference between these edit lists?

  2. #2
    Columbia, MO
    CCI edits consist of 2 types of edits the first being the one you are most familiar with,
    Component of comprehensive
    2 or more procedures where 1 or more of the listed procedures is consider to be a component of the more comprehensive procedure.
    the other type of edit you may not be as familira with
    Mutually exclusive
    2 procedures that are considered to be impossible or improbably to be performed on the same patient on the same day. Some combinations are modifiable and some are not. Just be sure to use the correct modifier.
    I hope this is of assistance for you.

    Debra A. Mitchell, MSPH, CPC-H

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