Forum - Questions & Answers
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.
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