Please note that this article contains information that is only relevant to American clinics.
Every quarter, the Centers for Medicare and Medicaid Services (CMS) present new changes based on the Correct Coding Initiative (CCI)–these are known as the ‘CCI Edits‘.
The CCI was established to help promote the correct coding methodologies, as well as curtail improper coding, which often results in inappropriate payment in Medicare Part B claims.
In addition, the CCI edits check for any mutually exclusive pairs of codes. This helps ensure that only the appropriate codes are grouped and priced.
An overview of the CCI edits can be accessed at any time through the CMS website. PTs, OTs, and SLPs in private practice, or who own their own clinics should click on NCCI Edits—Physicians. But, if you’re working in a different treatment setting, click on NCCI Edits—Hospital Outpatient PPS. Check out the link below to access the CCI Edits Overview:
Gawenda Seminars and Consulting has been kind enough to prepare a ‘cheat sheet’ to help you with the latest CCI Edits. Their document contains the most commonly used CPT codes by PTs, OTs, and SLPS. It also lists what can and cannot be billed on the same date of service by the same provider.
We hope that you found this article helpful. Click here to learn more about the benefits of becoming a Gold Member of the Gawenda Seminars and Consulting website.