RebeccaM

I need help understanding CCI edits column 2 & 4.  If column 2 shows "1" but column 4 (delete date) shows a date does that mean I can bill the codes together or not? Thank you,

Comments

  • Trying to figure out if 29823 can be billed with 29827.
  • Hi Rebecca I believe the indicators are what you need to base the assignment on. Reference below:

      Each edit pair has a modifier indicator in the NCCI edit file.  This indicators are:

    • 0 – no NCCI-associated modifier can be used with this code pair as there are no circumstances where both procedures should be paid on the same date of service.
    • 1 – NCCI modifier may be reported when appropriate.
    • 9 – NCCI edit does not apply to this code pair – the edit has been deleted retroactively.
    Review the code pairs for which the denials are occurring. They may have a modifier indicator of zero (0) and no modifier is ever going to allow payment of the component/column 2 code. 
    1 – NCCI modifier may be reported when appropriate.9 – NCCI edit does not apply to this code pair – the edit has been deleted retroactively. 
  • That is what I thought but wanted some input in case I was missing something. Thank you.
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