2017 Updates for NCCI Edit Coding Policy Manual

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Go Over the NCCI Edit Coding Policy Manual in Detail to Understand the Changes for 2017

Since the early 1990’s CMS has been developing the National Correct Coding Initiative or NCCI. NCCI is a very large set of edits that involve CPT® and HCPCS codes that are not to be used together. Originally developed for physicians, these edits are now also used by hospitals for outpatient coding. Along with this set of edits there is a rather extensive set of coding policies that form the basis for the actual NCCI edits. As CPT® and HCPCS are updated, generally expanded, this policy manual is also updated. While additions are easy to find, deletions sometimes go unnoticed.

Join industry veteran Duane C. Abbey, Ph.D., in this audio session that provides hospital staff with 2017 NCCI updates to help them remain resourceful. Coding and billing staff must be fully conversant with these coding policies since third-party payers may also use some, all or even more of these coding/billing policies. To understand these changes, not only must these coding policies be read, the language is sometimes arcane and must be studied with care. Duane will go over these changes in detail so that your coding and billing staff remain on top of all the changes.

Teleconference Objectives:

  • Review the new/changed CPT® codes for 2017.
  • Review the new/changed HCPCS codes and modifiers for 2017.
  • Review the proper use of the 25 modifier.
  • Review the proper use of the 59 and related modifiers that circumvent the NCCI edits.
  • Learn about the changes to MUEs (Medical Unlikely Edits).
  • Understand the National Correct Coding Initiative coding policies as they related to modifier utilization.
  • Appreciate the OIG’s finding and compliance concerns for the NCCI edits.
  • Review the new and/or changed general coding/billing policies.
  • Review the new and/or changed specialty coding/billing policies.
  • Appreciate the compliance issues surrounding hospital use of these coding/billing policies.

Session Agenda:

  • Overview of NCCI Edits and Coding/Billing Policies
    • Brief History of the Coding/Billing Policies
    • Types of Edits
    • Obtaining the NCCI Coding Policy Manual
    • Using and searching the NCCI Coding Policy Manual
  • Overview of Modifiers Used with NCCI Edits
    • “-59” Modifier
    • “-25” Modifier
    • Differences Between Physician and Hospital Utilization
    • Hospital vs. Physician NCCI Edits
  • 2017 Updated to CPT/HCPCS
    • Review of New/Modified CPT® Codes
    • Review of New/Modified HCPCS Codes
    • Review of New Modifiers
  • Review of 2017 NCCI Coding Policy Manual Changes
    • General Guidelines
    • Specialty Area Guidelines
    • General Policy Trends
  • Compliance Issues
    • Audit Procedures for Proper Use
    • Recovery Audit Contractor (RAC) Involvement
    • OIG Concerns
    • Private Third-Party Payers
  • Case Studies and Exercises
  • Sources for Further Information

Who should attend?

  • Coding Personnel
  • Billing and Claims Transaction Personnel
  • Charge master Coordinators
  • Financial Analysts
  • Compliance Personnel
  • Physicians
  • Internal Auditing Staff
  • Other Interested Personnel

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
More Events By The Speaker

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