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CodeMap Compliance Briefing: 6/20/03: Correct Coding Edits

Editor's Welcome:

We have received numerous questions about Correct Coding Initiative or CCI Edits. The following compliance briefing will explain what CCI edits are, and how they affect claims for services provided to Medicare beneficiaries. As always please do not hesitate to forward questions, comments, or suggestions for future CodeMap Compliance Briefings.  

Sincerely,

Charles B. Root, Ph.D.

Correct Coding Initiative Edits:

The first series of coding edits became effective in early 1996. Since that date, thousands of coding edits have been added, deleted or revised. It is important that you refer to the most current CCI edits when submitting Medicare claims.

Edits are used by Medicare to deny claims based on inappropriate CPT code usage. If you have received remittance advice with messages such as the following, then you know that a CCI edit has had an effect on your Medicare reimbursement.

"Claim/service denied/reduced because t....

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