Forum - Questions & Answers

Dec 3rd, 2014 - stomach1 3 

Ncci edits

I am getting a NCCI Edit rejection for 93000 & 93268, however, I am having a difficult time trying to identify this edit. Would the 93000 be payable & appropriate with the modifier 59?

Thank you for your help.

Dec 3rd, 2014 - Jackfraust 69 

re: NCCI EDITS

go to:
www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

Scroll to "Related Links" and choose Physician coders or Hospital (facility coders) there will be a download filter this for the codes you want to see if they are bundled.

I looked under physicians- and it looks like two of your codes are bundled with a superscript 1

6th column (superscript):
0 = there are no modifiers associated w/ NCCI that are allowed to be used w/ this code pair. There are no circumstances in which both procedures of the code pair should be paid for the same beneficiary on the same day by the same provider.

1 = modifiers associated with NCCI are allowed with this pair when appropriate

9 = NCCI edit does not apply to this code pair.

You should be able to use a modifier with these two codes



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