what is CCI edit? understanding of column 1 and column 2
What is the column 1/column 2 correct coding edit table?
The column 1/column 2 correct coding edit table contains two
types of code pair edits. One type contains a column 2 (component) code which
is an integral part of the column 1 (comprehensive) code. The other type
contains code pairs that should not be reported together where one code is
assigned as the column 1 code and the other code is assigned as the column 2
code. If two codes of a code pair edit are billed by the same provider for the
same beneficiary for the same date of service without an appropriate modifier,
the column 1 code is paid. If clinical circumstances justify appending a
CCI-associated modifier to the column 2 code of a code pair edit, payment of
both codes may be allowed
What is the mutually exclusive edit table?
The mutually exclusive edit table contains edits consisting
of two codes (procedures) which cannot reasonably be performed together based
on the code definitions or anatomic considerations. Each edit consists of a
column 1 and column 2 code. If the two codes of an edit are billed by the same
provider for the same beneficiary for the same date of service without an
appropriate modifier, the column 1 code is paid. If clinical circumstances
justify appending a CCI-associated modifier to the column 2 code of a code pair
edit, payment of both codes may be allowed (see section entitled "CCI
Modifiers").
What are Correct Coding Initiative (CCI) edits?
Correct Coding Initiative (CCI) edits are pairs of Current
Procedural Terminology (CPT) or Healthcare Common Procedure Coding System
(HCPCS) Level II codes that are not separately payable except under certain
circumstances. The edits are applied to services billed by the same provider
for the same beneficiary on the same date of service. All claims are processed
against the CCI tables.
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