Keep pace with the latest CCI edits and be a success

Developed by CMS with an end to promotefor an electronic version. CMS decided to post the
national correct coding methodologies and doinformation sensing that it was unfair that
away with improper coding, the Correct Codingphysicians had to purchase Medicare’s rules.
Initiative (CCI) edits are used by Medicare andApart from specific CCI codes, the CMS website
other payors to bundle procedures that shouldcontains three sections: a policy manual for
have been billed separately. There are CCI editsMedicare Part b carriers, relevant Medicare
for both physician services and hospital outpatientregulations from the “Medicare Carriers
services.Manual” section 4630; and CCI questions and
The latest package of CCI edits version, Versionanswers.
15.3, which will be effective from October 1, 2009Few things that you will do well to know about
will encompass all previous versions and updatesCCI codes :
from January 1, 1996, to the present. They areYou can appeal a payment decision involving a
organized in the following tables – Column OneCCI edit.
/Column Two Correct Coding Edits, and MutuallyWhen clinical circumstances demand, a CPT or
Exclusive Code (MEC) edits.HCPCS modifier will override a CCI edit.
To code right, you need to keep pace with theCCI coding policies are based on AMA’s CPT
latest CCI codes. Medicare makes its CCI editsmanual, national and local policies and edits, coding
available online for free. The decision was takenguidelines developed by national professional
because previously physicians had to shell outsocieties, etc.
$300 a year for a print version or $260 a year