We know medical coding can be tough, but at Rivet, we're dedicated to simplifying it for you. Introducing our latest enhancement: NCCI Procedure-to-Procedure/CCI and Medically Unlikely edits are now seamlessly integrated into the estimate creation process. In simple terms, if you enter two codes that Medicare won't allow billed together or input too many units, Rivet will give you a heads-up!
In this guide, we'll walk you through the process of using this feature effectively.
NCCI edits included in Rivet
Warnings users may encounter
Configuring edits within your account
Additional Resources
1. Understanding the CMS NCCI edits included in Rivet
We’ve added the following CMS edits to our Patient Pricing application. Please note the specific treatment types where these apply:
2. Warnings users may encounter
To keep you informed and in control, we’ve added the warning messages to our system. These warnings will alert you when a potential billing conflict or error is detected during the estimation process. See the examples below.
While these warnings are valuable, we understand that sometimes users may want to proceed with their estimates without adjustments. Therefore, we have designed the feature to be non-intrusive, allowing users to continue without it being a hard stop.
3. Configuring edits within your account
To streamline your experience and ensure compliance across various payer types, we have configured the NCCI Edit feature with the following settings:
By default, this feature is disabled for Medicare, Medicare Advantage, and Commercial Payers.
For those who wish to enable this feature to enhance your experience, you can adjust the configuration by following these steps.
Click on your account name >account
Click on Estimate at the bottom left
Click on the Benefits tab
From here you can click the Dropdown menu in the NCCI Medicare Edits section.
You can select the following options:
Disable the feature
Enable edits for Medicare & Medicare Advantage plans
Enable edits to Medicare, Medicare Advantage plans, and all commercial payers
4. Additional Resources
Where we get the information about these edits:
Where you can learn more about these for Medicare and Medicaid:
If you have any additional questions about the NCCI Edits feel free to chat in or send an email to success@rivethealth.com.
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