Q&A: Keeping up with add-on code edits

Q: Where can I find the most recent list of add-on code edits? How often is it updated?

A: CMS provides the list of add-on code edits on its NCCI website. If an add-on code is reported without a primary procedure code, then the claim will be rejected. Add-on codes cannot be reported separately or alone. These codes should be clearly identified in the chargemaster, and if this code is reported without a primary procedure code, then the provider’s system should have a flag that brings a claim like that under additional review.

CMS updates the list of add-on codes with their primary procedure codes on an annual basis based on changes made in the CPT Manual.

For more information, see The Contemporary Guide to Patient Financial Services.