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Outpatient Facility Coding Alert

Reader Question:

Dive Deep Into This NCCI Edit Rule

Question: We’ve begun receiving denials when reporting 36478 with 36471. I found the Centers for Medicare & Medicaid Services (CMS) introduced a new National Correct Coding Initiative (NCCI) edit that bundles these codes with a modifier “1” indicator. Can I still report them separately? Indiana Subscriber Answer: You are correct that as of October 1, 2019, a new NCCI procedure-to-procedure [...]