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The following Q&A comes from the Centers for Medicare & Medicaid Services website.
Q: When Correct Coding Initiative (CCI) edits for certain services do not apply under the Outpatient Prospective Payment System (OPPS), is it appropriate for a hospital to report a pair of codes for for which a CCI edit exists for physician payment?
A: Not necessarily. Exclusion of CCI edits for certain services under the OPPS does not imply that reporting the affected code pairs under the OPPS is appropriate. Hospitals should follow the CPT code descriptors and guidance, and utilize any additional CMS guidance, in reporting services.
Source: CMS
Related Articles to CMS Q&As:
CMS: How to Notify RACs of Self Audits
CMS Highlights Differences in RAC Appeal Process and Regular Medicare Appeal Process
CMS: RACs Will Pay For Medical Record Photocopies
The following Q&A comes from the Centers for Medicare & Medicaid Services website.
Q: When Correct Coding Initiative (CCI) edits for certain services do not apply under the Outpatient Prospective Payment System (OPPS), is it appropriate for a hospital to report a pair of codes for for which a CCI edit exists for physician payment?
A: Not necessarily. Exclusion of CCI edits for certain services under the OPPS does not imply that reporting the affected code pairs under the OPPS is appropriate. Hospitals should follow the CPT code descriptors and guidance, and utilize any additional CMS guidance, in reporting services.
Source: CMS
Related Articles to CMS Q&As:
CMS: How to Notify RACs of Self Audits
CMS Highlights Differences in RAC Appeal Process and Regular Medicare Appeal Process
CMS: RACs Will Pay For Medical Record Photocopies