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Several procedure-to-procedure (PTP) edit changes in the Medicare National Correct Coding Initiative (NCCI) database will go into effect July 1. The quarterly update files are now available on the Centers for Medicare & Medicaid Services (CMS) website. Most of the changes account for new CPT® codes added for 2020 or codes that will be deleted […]
The post NCCI Tightens Up Cardio, Lab Edits July 1 appeared first on AAPC Knowledge Center.
The MACs to implement logic that ensures they bypass payment window edits (3-days and 1-day) when processing claims for donor post-kidney transplant complications services. MACs will hold certain claims, as noted below, until Medicare’s Common Working File (CWF) system edits these claims correctly.
We have always billed this way to Medicare and it paid, just started receiving these denials in the last 3-4 weeks.
Any ideas.
The CPT® codes that are considered a laboratory test under the Clinical Laboratory Improvement Amendments (CLIA) change each year, as well as throughout the year, making it difficult for healthcare providers and laboratories to keep up. Here are the CPT codes for 2019 that are subject to or excluded from CLIA edits in easy-to-look up […]
The post 2019 Codes Subject to or Excluded from CLIA Edits appeared first on AAPC Knowledge Center.
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Avoid payer denials by ensuring your provider or supplier follows the rules for allowable MUE units. Understanding why Medically Unlikely Edits (MUEs) were established, how they are organized, and the criteria on which edit rationales are based may help medical coders and billers avoid denials or, at a minimum, properly resolve a denial. What Are […]
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I am in search of a remote medical coder/ claim edits position
Previous experience handling claim edits for wound care management.
Thank you, have a great day.
Scrubbing is the best way to ensure your claims are clean of unbundling overpayments. A hospital finance department should not treat National Correct Coding Initiative (NCCI) edits as irrelevant to inpatient billing simply because payers don’t use the NCCI to edit inpatient claims before payment. Instead, hospitals should institute internal controls to ensure claims are […]
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