Practice Management Alert

Not overriding when you can means missing billable services. When a payer blames claim denial on the Correct Coding Initiative (CCI) bundles, do you know what that means? If you don't understand what CCI edits are, how they work, and how they affect your claims, you're risking denials, fraud charges, and lost reimbursement. Check out these top three frequently asked questions -- and expert answers -- to increase your CCI know-how. 1. What Is a CCI Edit? Every quarter CCI puts out a list of code pairs that Medicare -- and many private payers -- follow when they reimburse physician practices. The CCI edits list pairs of CPT and HCPCS codes that payers will not pay on when you bill them together. Medicare and other payers apply these edits to services you bill for the same provider, for the same beneficiary, and on the same date of service. "All edits consist of code pairs [...]