The January 2013 “Practice Management” column asked if 2013 would be the year of the audit. That article included a rundown of the entities that could be conducting pre- or post-payment reviews on the claims you submit for your services. As mentioned, the National Correct Coding Initiative (NCCI) is one of the more frequently cited reasons behind claims review. The NCCI was developed to promote correct coding and to prevent improper coding that can lead to improper payments. In this article, we will take a deeper look at the NCCI and what you need to know to make sure you are following it correctly.
The NCCI includes a volume of code pairs, termed “edits,” that set limits on which procedures can be reported together (Column One/Column Two edits). NCCI code pair edits are automated prepayment edits that prevent payment for one of the services when certain codes are reported together....
