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Orthopedic Coding Alert

Remember the Difference Between ME and NME Edits

Published on Sat Mar 27, 2010

CCI edits fall into two camps: mutually exclusive and non-mutually exclusive. Mutually exclusive edits are those where the code pair "represent procedures or services that could not reasonably be performed at the same session by the same provider on the same beneficiary," according to CMS. Medicare will only reimburse you for the lesser-valued of the two procedures. Non-mutually exclusive edits pair codes for two services that physicians often perform during the same session. CCI lists one code as the comprehensive procedure -- meaning it's considered the larger procedure --and the second code as the component, which is a piece of the comprehensive.
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