Understanding Medicare's NCCI: Logic and Interpretation of the Edits
Understanding Medicare's NCCI is the only resource that provides healthcare professionals a better understanding of Medicare guidelines for the National Correct Coding Initiative (NCCI). It helps those using the CPT and HCPCS code sets for reimbursement and builds understanding of the logic behind the NCCI bundling.
For anyone using CPT and HCPCS code sets for reimbursement, this book provides an insider's guide to the thoughts behind Medicare's initiative and NCCI reimbursement. It takes coders, providers and payers through the logic of the NCCI edits and teaches them how to make the correct determination about NCCI bundling vs. billing separately for edited services.
This text teaches coders, providers and payers how to determine the correct approach to NCCI edits. Expanding on Medicare guidelines, this guide features:
- Explanations of the logic behind NCCI code pairs to help make quick coding decisions
- Chapters organized by CPT code sections provide specific guidelines from Centers for Medicare & Medicaid Services to implement strategies to analyze and interpret guidelines
- Explanations of modifier applications help to detail appropriate modifiers to decrease confusion that may be used to bypass edits
- Case studies that highlight coders' common questions and offer suggestions to help ensure appropriate payments are received without coding errors
- Checkboxes to help easily determine the most important points of each section
- Documentation tips to instruct clinicians on the proper level of documentation