CMS Reinstates CCI Edits, “Sort Of”

As you’ve heard, CMS will “reinstate” the January 1, 2020 CCI edits as of October 1st, 2020.

“Sort of”

CMS’s broad-brush statement, “reinstating previous CCI edits”, is misleading:

Only some of the edits are returning on October 1st
Second issue, the numerous other payers who follow Medicare rules will adopt these same CCI edit changes on their own individual timelines

Sporadic denials are inevitable

As of October 1st, HardStop™ Medicare validation will block therapists from signing notes when coding is not compliant with CCI edits. As Systems4PT tracks hundreds of thousands of claims, the moment that AARP, BCBS Medicare Advantage, Humana and other payers independently adopt the new rules, those individual payers will be updated in all Systems4PT practices. Instantly, HardStop™ Medicare validation will guide therapists toward clean claims that get paid.

No cheat sheets. No staff meetings. No surprise rejections as payers change independently.

You can spend your time hands-on treating patients. Systems4PT and HardStop™ Medicare validation will simplify burdensome coding changes.