Question: NCCI code edits and MUE are used to determine whether or not procedure codes on a claim are billed together in appropriate ways. Because of
NCCI code edits and MUE are used to determine whether or not procedure codes on a claim are billed together in appropriate ways. Because of the way computer programs work, the Practice Management Program your future practices use (if they use them) may not have the most up-to-date information on code edits, so understanding where to find code edits, how these code edits work, and how to read them, can mean the difference between getting paid for a correctly billed claim in a timely fashion, and having a lengthy adjudication process because a claim needs to be rebilled.
In this week's discussion, you will have the opportunity to locate and discuss a code edit of your choice. For your Main Post, please do the following:
- Select a code edit from the lists below
- Explainthe codes that are involved in the edit. Look them up using your CPT manual or a website like findacode.com For example:
- "This edit involves CPT code 17274, Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia, and CPT code 99220, New or Established Patient Initial Hospital Observation Care Services.
- Using the information in the edit, explain why you think these two codes cannot be billed together.
Code edits can be very complicated, so the goal of this exercise is simply to increase your comfort levels with reading them and thinking through them.
In your follow-up posts to your peers, contribute to the learning of the team by responding to the posts of at least two of your peers with the following:
- Based on what you know, offer agreement that your peer is interpreting the edit correctly
- Based on what you know, offer clarification for a code edit your peer has interpreted
Due to the nature of the information in this Discussion post, there is no minimum word requirement. However, you are expected to answer all questions as thoroughly as possible, using complete sentences.
Step by Step Solution
There are 3 Steps involved in it
Get step-by-step solutions from verified subject matter experts
