# Inclusive???



## Sage123 (Nov 8, 2011)

Is there any way to see if something is inclusive other than getting a denial or trial and error?

Thank you.:


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## lpick (Nov 8, 2011)

*Claimcheck*

I am having issues too. Are you speaking of claimcheck? Tricare? BCBS? We are having issues with both.


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## mhstrauss (Nov 8, 2011)

SLP77 said:


> Is there any way to see if something is inclusive other than getting a denial or trial and error?
> 
> Thank you.:



CMS's NCCI Edits is usually a good place to start; here's the link:

https://www.cms.gov/NationalCorrectCodInitEd/NCCIEP/list.asp#TopOfPage

Select the code range for the codes you are dealing with, and it lists the codes that it considers included in a spreadsheet.


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## Sage123 (Nov 8, 2011)

Thank you mhstrauss. We have been using the NCCI but it's not showing anything. I was just wondering if there was another way other to know other than being told all the time.


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## Sage123 (Nov 8, 2011)

Ipick. 
I was just talking in the general sense. I've not heard of claimcheck yet. 
I used to work in follow up so I got real used to what was consider inclusive but now when coding it kind of changes things. Looks like I got my work cut out for me.
Thank you.


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## mhstrauss (Nov 8, 2011)

SLP77 said:


> Thank you mhstrauss. We have been using the NCCI but it's not showing anything. I was just wondering if there was another way other to know other than being told all the time.



Any particular scenario you want advice on?  I know all payers have their quirks about inclusions and such...really makes it difficult to know what you can actually code and still be compliant


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## mhstrauss (Nov 8, 2011)

SLP77 said:


> Ipick.
> I was just talking in the general sense. I've not heard of claimcheck yet.
> I used to work in follow up so I got real used to what was consider inclusive but now when coding it kind of changes things. Looks like I got my work cut out for me.
> Thank you.



I'm the same way.  I handled United Healthcare denials before I got my cert, and just got used to the way they did things.


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## Sage123 (Nov 11, 2011)

I feel for you on the UHC. I know how they are as well. Thank you but I don't have anything to give you.
I'm sorry. I thought maybe there was something else out there that might help but from what I can tell it's trial and error. Again thank you.


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## fishbite2 (Nov 12, 2011)

Some payors, including UHC, have claims/payment estimators on their websites. You put in the codes and diagnoses and it shows you how it will pay. Not foolproof but very helpful. I mainly rely the CMS NCCI Edits but not all payors follow them. Also, depending on your specialty the Coding Companion books have a lot of information on what is commonly considered to be inclusive.


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## Sage123 (Nov 16, 2011)

Thank you fishbite2.


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