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Frequently Asked Questions

FAQ: Why Does TCI SuperCoder Have Separate CCI Tools for Medicare and Medicaid?

 

TCI SuperCoder packages that include Correct Coding Initiative (CCI) procedure-to-procedure (PTP) edits provide tools for both Medicare edits and Medicaid edits. That is because each data set (list of CCI edits) is distinct. There is a lot of overlap between the Medicare and Medicaid edits, but assuming they are identical could lead to incorrect coding and payment. For Medicaid claims, you need to check Medicaid edits. For Medicare claims, you need to check Medicare edits. 

 

In packages like Fast Coder, Physician Coder, Multispecialty Coder, and Facility Coder, check practitioner CCI PTP edits using these features (MCR is Medicare and MCD is Medicaid):

 

  • On the Coding Tools page, use the MCR CCI Edits Checker or MCD CCI Edits Checker widget.
  • Access these same CCI widgets on the more focused Claims Edits Coding Tools page by selecting Claims Edits from the top ribbon menu on the Coding Tools page.
  • Open a page with a single CCI tool by opening the Claims Edits menu on the left side of the Coding Tools page and clicking the Edits Checker you want to use.
  • On your CPT® code details page, check under Compliance Tools for tabs that let you view codes that are in the column 2 position in CCI edits with your chosen code.

 

Tip: Outpatient Facility Coder users also have access to outpatient Medicare and Medicaid CCI edit tools included in their coding package.