The Centers for Medicare & Medicaid Services (CMS) released an article regarding the quarterly update to the Correct Coding Initiative (CCI) edits, effective April 1, 2006. Physicians may view the current CCI edits and the current Mutually Exclusive Code (MEC) edits on the CMS Web site, which will be updated with the Version 12.1 edits as soon as they are effective. The CCI was developed to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Medicare Part B claims. CMS developed its coding policies based on coding conventions defined in the American Medical Association’s CPT manual; national and local policies and edits; coding guidelines developed by national societies; analysis of standard medical and surgical practices; and a review of current coding practices. The purpose of the CCI edits is to ensure the most comprehensive groups of codes are billed rather than the component parts. Additionally, CCI edits check for MEC pairs to ensure that only appropriate codes are grouped and priced.

Read the CCI edits article (pdf) now.