HOw to check CCI edit for two procedure whether accepted or
not
If I want to determine what codes/procedures are paired with
a certain code, how can I find this out?
NTIS provides the printed versions of column 1/column 2
correct coding edits and mutually exclusive code edits sorted/sequenced in two
ways - by column 1 code and by column 2 code. If a single code is found in both
sorts, then you should have all the current code combinations active in the CCI
with this certain code in either the column 1 or column 2 position. The NTIS
electronic version allows you to search for a code in the database in either
position. CMS provides the electronic version of column 1/column 2 correct
coding edits and the mutually exclusive code edits. Both tables are sorted by
column 1 and column 2 edits.
How do I report medically reasonable and necessary units of
service in excess of a Medically Unlikely Edit (MUE) value?
since each line of a claim is adjudicated separately against
the MUE value for the code on that line, the appropriate use of Current
Procedural Terminology (CPT) modifiers to report the same code on separate
lines of a claim will enable a provider/supplier to report medically reasonable
and necessary units of service in excess of an MUE value. CPT modifiers such as
-76 (repeat procedure by same physician), -77 (repeat procedure by another
physician), anatomic modifiers (e.g., RT, LT, F1, F2), -91 (repeat clinical
diagnostic laboratory test), and -59 (distinct procedural service) will accomplish
this purpose. Modifier -59 should be utilized only if no other modifier
describes the service
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