Q&A: Understanding NCCI edits for bundled CPT codes

QUESTION: I am trying to understand the terminology for ‘0,’ ‘1,’ and ‘9’ in the modifier column of the National Correct Coding Initiative (NCCI) edits for CPT codes 80000–89999 column1/column2.

We receive rejections when we report CPT codes 84436 and 84439 together as well as when we report CPT codes 84479 and 84439 together. CPT codes 84436 and 84479 are components of CPT code 84439. It is my understanding that the indicators in the modifier column denote the following:

  • 0: Not allowed
  • 1: Allowed
  • 9: Not applicable

Because a ‘0’ appears in the modifier column for each of the codes mentioned above, please clarify whether a modifier is allowed when reporting codes 84436 and 84479, which are normally bundled into the procedure for code 84439.

This is an excerpt from a member only article.
To read the article in its entirety, please login.