Health Information Management

Q/A: National Correct Coding Initiative edits

APCs Insider, January 6, 2012

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Q: What advice can you offer providers with respect to 2012 OPPS and National Correct Coding Initiative (NCCI) edits? What must we address internally until the system catches up?

A: The system is fast-forwarding ahead one quarter this month. Transmittal 2370, which includes updates to the Integrated Outpatient Code Editor (I/OCE) for 2012 states:

Note: In the past the CCI edits have been one quarter behind. Effective for January 1, 2012, the current quarter (Version 18.0) of the CCI edits will be implemented.

This is a huge change for providers and they need to ensure that their internal scrubbers and editors are updated with the correct version. Providers must implement any updates from the previous quarter that is usually in effect for January but is being skipped this year to bring the edits on the Part A side in concert with those on Part B.

Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.



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