All Entries Tagged With: "Injections and infusions"

Watch for missing drug injection and infusion NCCI edits

As many of you know, CMS maintains two sets of NCCI edits: one for hospitals and one for physicians. The hospital version of the edits is one quarter behind the physician version. This can cause significant compliance issues for hospitals.

CPT and HCPCS codes are generally updated January 1 of each year. However, because the NCCI edits for hospitals are one quarter behind, the edits that apply to hospitals during the first quarter of a year are the edits for the fourth quarter of the prior year. This would mean that any new codes, adopted January 1, would not be included in the edits for the first quarter. This is especially problematic this year because of the new renumbered drug infusion and injection codes, which are subject to many bundling edits. [more]