News: CCI Edits in April 2017

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.


Click here to read about the CMS CCI edits in January 2017.


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:


The complete CCI Edits Overview can be accessed here.


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.


Click here for CCI Private Practices Edits (effective April 1, 2017).


Click here for CCI Non-private Practice Edits (effective April 1, 2017).


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