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What are the 2 NCCI edits?

User Mrroboaat
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Final answer:

The two NCCI edits are the Column One/Column Two Correct Coding Edit, which involves a pair of codes with one representing a comprehensive service and the other a component of it, and Mutually Exclusive Edit, which prevents payment for procedures that cannot be reasonably performed together. These are used to prevent improper Medicare Part B payments.

Step-by-step explanation:

The two National Correct Coding Initiative (NCCI) edits are procedural coding edits designed to prevent improper payment when incorrect code combinations are submitted on Medicare Part B claims.

  • Column One/Column Two Correct Coding Edit: This type of NCCI edit involves a pair of codes in which one code represents a comprehensive service and the other code represents a component of the comprehensive service. When billed together, Medicare will pay only for the comprehensive code.
  • Mutually Exclusive Edit: These edits prevent payment for two procedures that due to their nature cannot reasonably be performed together. An example might include a procedure to remove an organ that has previously been removed.

Understanding these edits is crucial for proper billing and avoiding claim rejections when providing medical services billable to Medicare.

User Kiriloff
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