What is the effect of an NCCI edit?

• A. It will automatically approve all codes
• B. It may trigger a denial or require code modification to comply with coding rules
• C. It adds CPT modifiers automatically
• D. It alters the patient's medical record

Answer: (B)

NCCI edits are rules that prevent improper coding by checking which code pairs should be bundled together and which can be billed separately. They don’t automatically approve anything; instead they flag combinations that don’t align with established coding rules. When a pair is in an edit, the claim may be denied for one of the codes, or you may need to modify the codes or apply an appropriate modifier to show that the procedures were performed as separate services. This is why the effect is that it may trigger a denial or require code modification to comply with coding rules. It does not automatically approve codes, add modifiers on its own, or change the patient’s medical record.