Primary Care Coding Alert

One more private insurer has kissed confusing code bundles goodbye and welcomed more lucid Correct Coding Initiative (CCI) edits. The payer is also changing its rules for reporting certain modifiers. CIGNA Now Observes CCI, CMS Modifier Rules Beginning April 20, CIGNA will apply CMS National Correct Coding Initiative (NCCI) Incidental and Mutually Exclusive edits, according to the payers March 2009 Network News. CIGNAs use of the CCI edits should contribute to administrative simplification by allowing coders to use the same rules for CIGNA that they do for Medicare, explains Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians in Leawood, Kan. Because the CCI edits are readily available on the CMS Web site, CIGNAs use of those edits should make CIGNAs claim processing more transparent. Impact: If CCI bundles two codes, then CIGNA bundles two codes. The payer is also adopting CMS [...]