CCI Edits and the New Evaluation and Reevaluation CPT Codes

January 3, 2017
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Rick Gawenda
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The latest version of the Correct Coding Initiative (CCI) edits have been published by the Centers for Medicare and Medicaid Services (CMS). As expected, there are significant additions and deletions due to the new physical and occupational therapy evaluation and reevaluation CPT codes that became effective for dates of service on and after January 1, 2017.

The CCI edits are not only used by the Medicare program, but are also used by state Medicaid programs as well as some private insurance carriers and workers compensation carriers. Providers who are not aware of the CCI edits may not have all of their CPT codes paid for on a particular date of service.

Gawenda Seminars & Consulting has reviewed the updated version of the CCI edits and has updated their quarterly CCI edit “cheat sheet” to assist our Gold Members with accurately using modifier 59 on CPT codes when it is necessary. To access the latest version of the Gawenda Seminars & Consulting “cheat sheet”, click HERE. This “cheat sheet” will pay for your Gold Membership in just a few months.


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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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