Tag Archive | "NCCI"

CCI Modifiers: July 1 Update to Modifier 59 Rule Is Now in Force … and More

Tuesday, July 16, 2019

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Modifiers are the key to overriding Correct Coding Initiative (CCI) edits, so let’s give them the attention they deserve. We’ll start with a recent rule update and move on to helpful hints about CCI-associated modifiers in general. Which CCI edits? Our focus here will be Medicare CCI Procedure-to-Procedure (PTP) edits for physicians and practitioners. Do […]

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Make the CCI Manual Your Go-To Guide for Shoulder Arthroscopy With Debridement

Thursday, March 21, 2019

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Before you code debridement with shoulder arthroscopy, make sure you know what the Medicare Correct Coding Initiative (CCI) manual has to say. You’ll find the highlights here to help you get started. Where to look: You’ll find these instructions in chapter IV, section E, of the Medicare CCI manual. Same Shoulder? Stick to the Basic […]

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Modifier 59 Misuse Cost 1 Health System Millions — Know Where to Go for the Rules

Monday, January 7, 2019

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Exploiting modifier 59 was a major factor in a recent $12.5 million settlement for False Claims Act allegations. How’s that for motivation to shore up your modifier 59 know-how? Here are some resources to get you on your way. Read the Write-Up on the Recent False Claims Act Settlement Find out some of the details […]

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2 Knee Arthroscopy Myths You Need to Bust Right Now

Wednesday, May 23, 2018

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There are a lot of possible variations for knee arthroscopy services, so you’ve got to know where to go for help on coding them. Make sure your knee arthroscopy claims don’t fall victim to these two error-causing myths! Follow the guidance in the Correct Coding Initiative manual. Myth: Report G0289 Along With 29880/29881 for Chondroplasty […]

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Know When CCI Manual Says to Use Bone Marrow Code 38222

Monday, March 19, 2018

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The addition of diagnostic bone marrow and biopsy code 38222 in the CPT® 2018 code set simplified coding in some ways (multiple procedures in one code), but there are still questions to be answered about how to handle specific scenarios. In case you missed it, the 2018 Correct Coding Initiative (CCI) manual answered some of […]

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CCI Errors: Some Moderate Sedation Pay May Be Delayed Until April

Friday, January 27, 2017

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  Seeing the new 2017 moderate sedation codes appear among the 99,490 new National Correct Coding Initiative (NCCI or CCI) edits wasn’t really a surprise, but a handful of those edits just might cause you some headaches all the same. The culprit? Modifier indicators. The good news? There should be a correction in the next […]

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CCI 2017 Manual Provides Shoulder Arthroscopy Answers You’ve Been Waiting For

Friday, November 18, 2016

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You know you’re a coder when news that the new Correct Coding Initiative (CCI) manual out makes you a little giddy. (There’s a good chance I said the same thing about CPT® 2017 when it came out.) I’ve been watching for the CCI manual update ever since the deletion of certain shoulder arthroscopy edits raised questions […]

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