Please Note: There is no Medicare information on our corporate website. Please select a specific contract in the 'Search Within' box for Medicare related information.
© 2019 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
Printed Date: 9/22/2015
Outpatient Code Editor (OCE) has identified a component of a comprehensive procedure reported on same date of service.
Explanation and Suggestion:
National Correct Coding Initiative (NCCI) is developed to prevent inappropriate payment of services that should not be reported together. It contains codes that are not separately payable except under certain circumstances. All claims processed against NCCI tables. There are two NCCI Edit Types:
Each code pair is assigned a modifier indicator:
Review Hospital Outpatient Perspective Payment System (OPPS) NCCI edits (Addendums A and B), compare the services and append an appropriate modifier, if applicable.
Note: If an adjustment needs to be submitted to correct billing errors on a rejected line item, then each applicable line item needs to be deleted and rekeyed in its entirety in order for the previous edit to be deleted. When adding or deleting a line, manually calculate the total charges on 0001 revenue code line.
When deleting & rekeying a revenue code line:
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 12/27/2018