CMS Simplifies CCI Edits

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In order to simplify the use of NCCI edit files, CMS will consolidate the two

edit files into the Column One/Column Two Correct Coding edit file. Separate

consolidations will occur for the two practitioner NCCI edit files and the two

NCCI edit files used for OCE. This change will occur for practitioner NCCI

edits in NCCI version 18.1 scheduled for April 1, 2012. After these changes

occur, it will only be necessary to search the Column One/Column Two Correct

Coding edit file for active or previously deleted edits. Effective April 1,

2012, CMS will no longer publish a Mutually Exclusive edit file on its website

for either practitioner or outpatient hospital services since all active and

deleted edits will appear in the single Column One/Column Two Correct Coding

edit file on each website. The edits previously contained in the Mutually

Exclusive edit file are NOT being deleted but are being moved to the Column

One/Column Two Correct Coding edit file.

Practitioner NCCI - In NCCI version 18.1 for practitioners scheduled for April

1, 2012, all edits in the Mutually Exclusive edit file will be moved to the

Column One/Column Two Correct Coding edit file with the same implementation and,

if relevant, deletion date as the edits have in the mutually exclusive edit

file. These edits are not being deleted from NCCI but are being moved to the

Column One/Column Two Correct Coding edit file. The net result will be that the

NCCI version 18.1 Column One/Column Two Correct Coding edit file will contain

all active NCCI edits and deleted NCCI edits that previously were contained in

the Mutually Exclusive and Column One/Column Two Correct Coding edit files. The

CMS website will have a single Column One/Column Two Correct Coding edit file

for practitioner NCCI.

Outpatient NCCI used in OCE - Effective April 1, 2012 the change will be

implemented on the CMS website where a single Column One/Column Two Correct

Coding edit file will appear which will contain all active NCCI edits and

deleted NCCI edits that previously were contained in the OPPS Mutually Exclusive

and Column One/Column Two Correct Coding edit files. These edits are not being

deleted from the OCE NCCI files but are being moved to the Column One/Column Two

Correct Coding edit file.

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.h\

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Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

www.gawendaseminars.com

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