An encoder warns of an NCCI conflict on a hospital outpatient account. What is the coder’s most appropriate next step?
Select an answer to reveal the explanation.
Short Explanation
When the encoder flashes an NCCI warning, it’s raising a hand—not handing you a blank check. Open the chart, see if the services were truly distinct, and only then decide on a modifier. Software can’t invent clinical justification for you.
Full Explanation
Encoder NCCI warnings require human review of the health record against edit and modifier criteria. Automatic acceptance of suggested modifiers, routine deletion of codes, or diagnosis manipulation to silence warnings is inappropriate. Documentation must support any override; encoders do not auto-justify bundling exceptions.