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Understanding CMS NCCI Edits and the Relative Value File
NCCI
- Procedure to Procedure Edits
- Medically Unlikely Edits
- Policy Manual
Relative Value File
- CPT/HCPCS Code status
- RVU Values
- Post-operative period
- Assistant at Surgery
- Supervision for diagnostic testing
- Bilateral procedures
Overview of the webinar
The National Correct Coding Initiative (NCCI) and the Relative Value File are two database files that the Center for Medicare and Medicaid Services(CMS) created for correct coding rules and guidelines related to Medicare claims. Most commercial carriers have also implemented these rules and guidelines in their claims processing in bundling services and other applications of coding of medical claims for professional providers. There is a wealth of information in these files to not only apply the rules and guidelines for clean claims but to also be able to defend coding submitted when it is denied.
Who should attend?
- Coders
- Billers
- Collectors
- Reimbursement Specialist
- Auditors
- Managers
- Supervisors
- Administrators
- Director of Quality Management
- Nursing Director
- Physician Advisor
- Hospitalist
- Case Managers
- Chief Medical Officer
- Chief Operations Officers
Why should you attend?
- Recognize the coding edits created by the Center for Medicare and Medicaid Services (CMS)
- Understand how insurance companies use the National Correct Coding Initiative (NCCI) to process claims
- Apply the policies and guidelines in the NCCI Policy Manual for clean claims
- Determine what you can apply to your coding and billing from the relative value file
- Create custom files with coding information for your practice
- Defend coding by using the NCCI and Relative Value File for appeals on denied claims
- Realize the Medically Unlikely Edits(MUE) for quantity billing and know that there are 2 parts
Faculty - Ms.Lynn Anderanin
Senior Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She is a former member of the American Academy of Professional Coders (AAPC) National Advisory Board, and has served on several other boards for the AAPC. She is also the founder of her local chapter of the AAPC. Her experience is primarily in the specialties of Orthopedics, Rheumatology, and Hematology/Oncology. She has been a speaker for many conferences, including the AAPC National Conferences and Workshops, Community Colleges, audio conferences, and Local Chapters. Lynn became a CPC in 1993, and a Certified Instructor in 2002, and a Certified Orthopedic Surgery Coder in 2009.