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Topic: Don't make assumptions based on NCCI edits

Ambulatory Surgery Reimbursement Update, August 12, 2008

National Correct Coding Initiative (NCCI) edits can introduce potential confusion when it comes to coding for urology code combinations. “Just because there’s no NCCI edit doesn’t mean that coders can make assumptions about the appropriateness of different code combinations,” says Glenn Krauss, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, an independent consultant based in Milton, WI. “There can’t be an edit for every single code pair.”

Coders need to step back and determine whether the code combinations make clinical sense, he says.

“Edits are in place for more common problematic code combinations that people use incorrectly on a consistent basis,” Krauss says. “This doesn’t mean you can code everything together.”

Editor’s note: This topic is from the August 2008 issue of Ambulatory Surgery Coding & Reimbursement Insider.

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