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Per CCI Guidelines Procedures Code XXXXX has an Unbundle Relationship With Procedure Code XXXXX Billed for the Same Date of Service. Review Documentation to Determine if a Modifier Override is Appropriate

Rejection Message Rejection Details Resolution

PER CCI GUIDELINES PROCEDURE CODE
XXXXX HAS AN UNBUNDLE RELATIONSHIP WITH
PROCEDURE CODE XXXXX BILLED FOR THE SAME DATE OF SERVICE.

REVIEW DOCUMENTATION TO DETERMINE IF A MODIFIER OVERRIDE IS APPROPRIATE

This rejection indicates that the claim has not passed “Smart Edits” put in place by the payer.

Smart Edits are based off of Correct Coding Initiative (CCI) rules and are designed to identify claims considered “Certain to Deny” due to billing issues.

Submitter Action:

Please review the claim to verify it is being billed appropriately. If your biller disagrees with the edit, you can simply rebill and resubmit the claim (without
making any changes), and it will pass Smart Edits. However, it may still deny upon adjudication.

Tip: Most Kareo PM subscription levels include access to a free code scrubbing tool on the Encounter. Utilizing this feature for all encounters can help prevent code rejections.

Note: Kareo Support cannot provide coding assistance. Please contact your biller/coder with any CPT or ICD code questions.

Update the claim/encounter information (if
necessary) then rebill and resubmit all affected
claims.