Claims & denials · Definition
NCCI edit (bundling): Definition
A CMS-published pair rule that prevents two codes from being paid together unless a modifier establishes they were distinct.
This is a short definition only. The full explanation lives on CO-97 bundling denials, which is the page to read if you are dealing with this on live claims.
Definition
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.
For worked examples, payer rules and documentation requirements, read CO-97 bundling denials. Return to the dermatology billing glossary.
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.