How to use CCI edit when procedure denied as bundled service

If I receive a denial for a procedure bundled into another service, and I cannot find this code pair in the column 1/column 2 correct coding list of edits, where else should I look?


Look in the mutually exclusive code list. The mutually exclusive code edits in the printed version of the CCI Edits Manual are in the same chapter but separate from the column 1/ column 2 correct coding edits. The electronic version of the mutually exclusive code edits that is available on the CMS website can be found in a separate listing at http://www.cms.hhs.gov/NationalCorrectCodInitEd/01_overview.asp, which are arranged by specific chapters.


What exactly does "column 1" mean in the column 1/column 2 correct coding edits table and in the mutually exclusive edits table?

Formerly known as the "comprehensive code" within the column 1/column 2 correct coding edits table, the column 1 code generally represents the major procedure or service when reported with the column 2 code. When reported with the column 2 code, "column 1" generally represents the code with the greater work RVU of the two codes.

However, within the mutually exclusive edits table, "column 1" code generally represents the procedure or service with the lower work RVU, and is the payable procedure or service when reported with the column 2 code

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