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CCI Edits

  1. Default CCI Edits
    Medical Coding Books
    I have a question in regards to CCI edits and comprehensive codes. I have only ever used 3M, which will indicate when you have unbundled a comprehensive code.

    I am wondering how other people determine which code is the comprehensive code and which one is bundled into the comprehensive code.

    For example, when I coded a hemorrhoidectomy (46260) and a Hemorrhoid ligation (46945), an edit popped up in 3M indicating that both these codes can not be billed together and than 46260 would be bundled into 46945.

    When I look these 2 codes up on the Ingenix Revenue Cycle Pro, and if I enter these 2 codes into the CCI Edit, it just indicates that these 2 codes can not be billed together. How do I know which one is bundled in with the other? I am sure there is a way to determine this, I just must be overlooking it.

    Anyone who checks edits this way, please let me know how you determine which code is bundled into the other one.
    Last edited by cordelia; 01-22-2012 at 05:11 PM.

  2. Smile Cci
    In this case, the 2 codes are mutually exclusive which can be verified on the CMS website MUE table. The allowed codes is listed in column 1 with the non- allowed code listed in column 2 and either 1 or 0 (in this case 0) specifying whether a modifier is allowed.

  3. #3
    I use MedAssets- Code Correct. This is a great tool to have for CCI edits.


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