CPT/CCI

The CodeCheck CPT/CCI interface allows you to check for CCI (Correct Coding Initiative) bundling edits, and test up to 50 CPT/HCPCS codes for CCI bundling edits. Additionally, you can view CCI edits with detailed rationale information.

Note: KnowledgeSource does not currently display the Medicaid NCCI edits.

Procedure

  1. Select CodeCheck > CPT/CCI. The CodeCheck CPT/CCI page opens in a new tab.

    Note: The Medicare and Version fields default to the correct values for your clinic selection, and version/date of service. You can change either field if necessary.

    • Effective 1/1/09, the Facility version of NCCI edits includes edits for the following categories of service: Anesthesia (00100-01999), E&M (92002-92014, 99201-99499), and MH (90804-90911). Prior to 2009, these code pairs were excluded from the Facility edits.
  2. Enter a list of CPT/HCPCS codes (up to 50), or add codes from Favorites.

Note: Commas, spaces, or semicolons can be used as separators.

  • Invalid codes cause the field to turn red. Hover over the code for an error message.
  • Duplicate codes are permitted.
  • To add codes from Favorites, click Favorites and select a code(s) from User or Clinic Favorites. Click Submit. The codes are added to the field.
  1. Click Submit. The results open, refreshing the page. 

    Note: Click Reset to clear the form before submitting.

    Click image to play video and click video to close.

  2. In the results panel:
    • Click Check Medical Necessity to enter a list of ICD-10 CM or ICD-9 Dx codes (up to 20) and click Submit. Use commas or semicolons as separators.
    • Click any hyperlinked code to navigate to the detail page.
    • If a modifier can be used to bypass the edit, there is a note in the CCI Modifier column. Click the note to see a list of the modifiers applicable to the Comprehensive/Column 2 code

  1. Go to CodeCheck > CPT/CCI.

  2. In the CCI Edit Informer Input panel, enter a HCPCS code(s).

  3. Select a date-of-service.

  4. Select a CCI type.

  5. Click Submit. The Edit Informer Results panel opens in full screen, displaying results.

  6. (Optional) Export the results to an Excel file.

  7. (Optional) Click Return to Form or in the top right to re-open the input panel.

    Click image to play video and click video to close.