Demystifying NCCI Edits and Hidden Medicare Coding Guidance

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Expert speaker Dr. Duane C. Abbey is taking an audio conference on NCCI Edits and hidden Medicare coding guidance on behalf of AudioEducator.com.

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Discuss the 2015 CMS Modifier “-59” reporting change with Dr. Duane C. Abbey

The CMS developed NCCI over a span of last two-decades. The National Correct Coding Initiative* (NCCI) endorses the correct coding methodologies to help reduce improper coding which may result in incorrect payments of Medicare Part B claims. The CMS came up with coding policies based on coding conventions defined in the AMA’s CPT manual, coding rules defined by national societies, guidelines of standard medical practices, and analysis of current coding practices. Annually, the CMS updates the NCCI policy manual, which is later used by the carriers as a general reference tool that describes the rationale for NCCI edits.

Although the NCCI edits are fairly common and recognizable globally, the coding manual that comes with NCCI edits are not as distinguished. The coding policies that are related with the NCCI edits started out as a clarification of why certain edits were established. Despite the fact that these edits have been developed for physicians, during the implementation of OPPS in 2000** half of the edits and the policies were extended to hospitals, which resulted in confusion and complexities as the coding for physician services is different from hospital services.

Expert speaker Dr. Duane Abbey is taking an audio conference “NCCI Edits and Hidden Medicare Coding Guidance” on Tuesday, Sep 23, 2014, where he will be discussing the overall development of the NCCI edits. Duane will review the reporting change of Modifier-59 and discuss how physicians and hospitals should use Modifiers in connection with the NCCI edits. Additionally, he will cover all the compliance issues – OIG studies, Audit procedures for proper use, recovery audit contractor involvement, and more!

Here’s a sneak peek of the session:

  • Discussion on the overall development of the NCCI edits
  • Insights on the NCCI edit coding policy manual
  • 2015 CMS Modifier “-59” reporting change
  • Insights on the compliance issues surrounding physician and hospital use of the “-59” modifier
  • Overview of the operational use of the National Correct Coding Initiative edits
  • Learn how physicians and hospital should use modifiers in connection with the NCCI edits.
  • Insights on the general and specific policies inherent in the NCCI guidelines
  • Find out the differences in coding policies between physicians and hospitals
  • The use of Modifiers with the NCCI policies
  • Discussion on definitions and descriptions in CPT/HCPCS
  • Utilization of key Modifiers for circumventing the NCCI edits
  • Provider coding, billing policies and procedures
  • Insights on editing software
  • Examine policies relative to specific service areas as delineated in CPT
  • Learn about the possible RAC and other audit activities in conjunction with the NCCI coding polices

For more information - http://www.audioeducator.com/hospitals-and-health-systems/ncci-edits-and-coding-policies-09-23-2014.html

About AudioEducator

AudioEducator brings the most compelling list of audio conferences and webinars on wide array of heath care topics—medical coding, billing, HIPAA compliance, ICD-10, EHR, and more. Get trained from the comfort of your home or office without spending a penny on travel. Pick a format of your choice for training— live conference/On Demand/ DVD/ PDF transcripts and start learning.
For more information, check - http://www.audioeducator.com

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Resource:
*http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html
**http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/HospitalOutpaysysfctsht.pdf

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