Claims & denials
NCCI edit (bundling)
A CMS-published pair rule that prevents two codes from being paid together unless a modifier establishes they were distinct.
What it means in dermatology
Procedure-to-procedure edits govern most dermatology surgical days: a biopsy bundled into an excision at the same site, a simple repair bundled into an excision, a destruction bundled into a Mohs stage.
Each edit carries an indicator showing whether a modifier can override it. Where the indicator is 0, no modifier will unbundle the pair and appealing is wasted effort.
Why it matters to your revenue
Understanding which edits are overridable determines whether an appeal is a recovery or a write-off with extra steps.
See this term in your own numbers
A free claims audit reviews a de-identified sample of your dermatology claims and returns a line-item findings report — including where terms like this one are costing you money.
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