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Editor's Welcome:

As promised, this week's briefing will discuss the CCI edits associated with laboratory and pathology procedure codes that became effective January 1, 2004. As always please forward any questions, concerns, or ideas for upcoming briefings via email.

Sincerely,

Charles Root, Ph.D.

CCI Edits Introduction

As noted last week, Correct Coding Initiative (CCI) edits are used by Medicare to deny claims based on inappropriate CPT code usage. CCI edits consist of pairs of CPT codes that Medicare has determined are not payable when performed together. If a provider submits a claim that is subject to a CCI edit, the Medicare carrier or intermediary will deny one of the CPT codes. If your laboratory or pathology provider organization is experiencing any unexplained denials from Medicare, make sure to check and see if a CCI edit might be causing the problem.

The following new CCI edits for laboratory and pathology services became effective January 1, 2004.  Some of the new edits concern new CPT codes an....

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