What are CCI and NCCI Edits?

What are CCI and NCCI Edits?

Question:
I hear you mention NCCI edits quite a bit. Can you give me a brief overview explanation on what NCCI edits are and how I can access them?

Answer:

Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC
CCO Program Director

Chandra Stephenson, Healthcon 2015 Headshots day2-200pxChandra has over 13 years coding and auditing experience and holds many certifications through the AAPC and AHIMA. She is a National ICD-10 Trainer for AAPC and served as a representative for the Great Lakes Region on the AAPC’s 2013-2015 National Advisory Board. She offers extensive experience in centralized billing, family practice, cardiology, GI, mental health, anesthesia, and multi-specialty environments. She has worked as an adjunct college instructor in medical coding, a compliance auditor for one of the largest healthcare systems in Indiana, and as a Big 5 consultant. She is currently an independent consultant and enjoys teaching and finding ways to simplify the world of coding accuracy and education.

Chandra has two miniature dachshunds, Buster and Cozy. When she isn’t spending time with her family, friends, and pups, she likes to travel and loves discovering hidden gems in each city she visits.
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Well first NCCI stand for National Correct Coding Initiative - or CCI for short. These are for CPT and HCPCS codes for physician and outpatient hospital settings. They affect reimbursement so they're important to understand.

The NCCI was created by CMS to
• Prevent unbundling of services;
• Prevent incorrect payments from being made due to inappropriate CPT and HCPCS code usage;
• Detect incorrect or inappropriate reporting of combinations of CPT and HCPCS codes; and
• Curtail improper coding practices that lead to inappropriate increased payment.

NCCI edits are performed on every possible pairing of CPT and HCPCS codes. They were developed and continue to be enhanced using:
• Coding conventions defined in the American Medical Association's CPT manual;
• National and local policies and edits;
• Coding guidelines developed by national societies;
• Analysis of standard medical and surgical practice; and
• Review of current coding practice.

More Videos:
Medical Coding Training — What Are CCI Edits?

[harisht]

When searching for a specific CPT in the CCI spreadsheet, I guess you can apply filters on row 3 with headers. You should be able to type a specific CPT in the search field. It will populate all the rows with only that CPT.