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Select Mutually Exclusive Edits in the Claim Edit Library
Check √ the appropriate CCI Mutually Exclusive edits as needed. You can set the CCI Mutually Exclusive edits with a Severity level based on business practices.
Mutually Exclusive Edit Example
Select Mutually Exclusive Edits in the Claim Edit Library
Help Guide for NextGen® Enterprise PM 8
Set Up CCI Edits
In File Maintenance, select Libraries > Claim Edits > Claim Edits Libraries. Select the applicable claim edit library. The Claim Edit Library Maintenance window appears. Check the appropriate CCI bundling edits as needed. You can set the CCI bundling edits with a severity level based on business practices. Select System > Payers, and then select the applicable payer. The Modify Payer Information window appears. Select the Practice tab, and then the Libraries tab on the bottom of the window. Attach the claim edit library to the payer by selecting a library in the Claim Edit Library field. Select OK. Bundling CCI Edits CCI Bundling Anesthesia Edits CCI Bundling Lab Edits Parent topic: CCI Edits
Help Guide for NextGen® Enterprise PM 8
Activating CCI Edits
If you want to include CCI edits among your activated Claim Edits, then you can select all the CCI edits. Selecting only some of the CCI Edits is not a best practice, this enables improper coding combinations to be applied to generated claims. Parent topic: CCI Edits
Help Guide for NextGen® Enterprise PM 8
Select Mutually Exclusive Edits in the Claim Edit Library
Check √ the appropriate CCI Mutually Exclusive edits as needed. You can set the CCI Mutually Exclusive edits with a Severity level based on business practices. Mutually Exclusive Edit Example Parent topic: CCI Edits
Help Guide for NextGen® Enterprise PM 8
Set Up CCI Edits
In File Maintenance, select Libraries > Claim Edits > Claim Edits Libraries. Select the applicable claim edit library. The Claim Edit Library Maintenance window appears. Check the appropriate CCI bundling edits as needed. You can set the CCI bundling edits with a severity level based on business practices. Select System > Payers, and then select the applicable payer. The Modify Payer Information window appears. Select the Practice tab, and then the Libraries tab on the bottom of the window. Attach the claim edit library to the payer by selecting a library in the Claim Edit Library field. Select OK. Bundling CCI Edits CCI Bundling Anesthesia Edits CCI Bundling Lab Edits Parent topic: CCI Edits
Help Guide for NextGen® Enterprise PM 8
Mutually Exclusive Edit Example
Skin preparation – Shave lesion (11301 – 11313) in conjunction with removal of skin tags (11200). The skin preparation would not be separately reported as the service is necessary to successfully accomplish the skin tag removal procedure. An encounter with CPT 11200 and 11305 codes will show on the Claim Production Status report with the following claim edit. Parent topic: Select Mutually Exclusive Edits in the Claim Edit Library
Help Guide for NextGen® Enterprise PM 8
Activating CCI Edits
If you want to include CCI edits among your activated Claim Edits, then you can select all the CCI edits. Selecting only some of the CCI Edits is not a best practice, this enables improper coding combinations to be applied to generated claims. Parent topic: CCI Edits
