Ob-Gyn Coding Alert

Challenge Inappropriate Bundling Edits

If you believe that you must take the National Correct Coding Initiative (NCCI) edits at face value and feel you have no power to change things, think again.

CMS has indicated that if you disagree with an edit, you may address your concerns and bundling issues by contacting AdminaStar Federal Inc. This company develops and refines the NCCI, coordinates the receipt of comments, prioritizes issues, reviews and researches previous actions, and discusses concerns with CMS. It will accept written comments by fax at (317) 841-4600 or by mail. The address is:

National Correct Coding Initiative
AdminaStar Federal Inc.
P.O. Box 50469
Indianapolis, IN 46250-0469
Attention to: Niles R. Rosen, MD, or Linda Dietz, RHIA, CCS, CCS-P
The company requires justification for any proposed modifications to the edits, of course. CMS has indicated that at a minimum you should include a comment letter that outlines the HCPCS/CPT codes and descriptors in question and the justification for the proposed change (for example, clinical medical literature, studies, standards of medical practice, national medical policy, National Specialty Society/Association coding guidelines, AMA coding instructions in CPT, or AMA coding advice in the CPT Assistant).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ob-Gyn Coding Alert

View All