NCCI FOR MEDICAL BILLERS  

Category: Billing

National Correct Coding Initiatives (NCCI) is a tool that coders can use when the provider has two CPT codes that are being billed to the insurance company for the same visit. As an example, Steve has chest pain. He visits his doctor who doesn't know if the chest pain is related to past heart attacks or if it is simply pain due to an injury. To rule out a heart attack or to determine if the pain is cardiac in nature, the doctor will most likely perform an EKG. Steve went to the doctor due to his chest pain, not to have an EKG performed. This is important because it validates the ability to bill an office visit in addition to the EKG. When the doctor sends the claim he/she will send the claim with an established outpatient Evaluation and Management (E/M) service and he will report the EKG with CPT 93XXX.

NCCI will tell us if the office visit (992XX) is payable when billed with ...