Claim denials related to National Correct Coding Initiative (NCCI) edits remain one of the most common and preventable challenges in optometric billing. They are often driven by incorrect code combinations, misuse of modifiers or insufficient documentation. Understanding how NCCI edits function in daily workflows is essential to improving claim accuracy, reducing rework and maintaining compliance. This issue provides a practical, real-world approach to identifying and preventing NCCI-related denials.
PECAA Max members can access The Coding Coach Online Library on the ‘Billing And Coding’ resource page within the member portal. Additionally, members can submit their unique coding issues to PECAA Billing and Coding Advisors Teri Thurston, Dianne Boulay and Cathy Uimari via the telephone hotline: 800.959.2020, Option 5, or email codingcoach@pecaa.com.
Teri is a revenue cycle professional with over 25 years of experience in the eye care industry. She has managed complex billing teams for ophthalmology and optometry practices. She has worked with various physicians to increase profitability, implement RCM efficiencies, and ensure billing compliance. She is passionate about supporting eye care professionals through billing and coding education.
With over 19 years in the optical industry, Dianne specializes in eye care billing and coding. Her background spans management roles in private practice and a leading RCM billing company, offering insight into billing efficiency and profitability. She partners with PECAA members to optimize RCM processes and financial performance. Holding CPOC and OCS certifications, Dianne exemplifies excellence and compliance in coding practices.
Cathy brings over a decade of expertise in medical billing, coding and revenue cycle management. With certifications as a Certified Professional Biller and Certified Professional Coder through AAPC, she has a proven track record of ensuring accuracy, compliance and efficiency in healthcare billing processes. Cathy is dedicated to helping providers navigate the complexities of billing and coding with confidence.