National Correct Coding Initiative

• Physician Edits: these code pair edits apply to physicians, non-physician practitioners, and Ambulatory Surgery Centers
• Hospital Outpatient Prospective Payment System Edits : these edits apply to the following types of bills: Hospitals, Skilled Nursing Facilities, Home Health Agencies Part B, Outpatient Physical Therapy and Speech Language Pathology Providers, and Comprehensive Outpatient Rehabilitation Facilities.

• Column1/Column2 Code Pairs: these code pairs were created to identify unbundled services. The name is derived from the fact that the code pairs are separated into two columns; Column 1 contains the most comprehensive code, and Column 2 contains component services already covered by that more comprehensive code. These code pairs are further categorized into two sets:
• * Modifier: the appropriate use of a modifier allows these code pair to be reported together. In most cases, the -59 modifier is used, although there are other acceptable modifiers. These modifiers must be supported by documentation in the medical record.
• * No Modifiers: these code pairs should never be reported together, regardless of modifiers.
• Mutually Exclusive Code Pairs : these code pairs should not be reported together because they are mutually exclusive of each other.