Profile Picture Jeff Chamblee

created May 23 2018

updated May 23 2018

Description

The CMS National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and reduces improper coding which may result in inappropriate payments of Medicare Part B claims and Medicaid claims.
NCCI procedure-to-procedure (PTP) edits define pairs of Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) codes that should not be reported together for a variety of reasons. The purpose of the PTP edits is to prevent improper payments when incorrect code combinations are reported.
Practitioner services also refers to ambulatory surgical centers.
DME refers to provider claims for durable medical equipment.
The CMS National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and reduces improper coding which may result in inappropriate payments of Medicare Part B claims and Medicaid claims. NCCI procedure-to-procedure (PTP) edits define pairs of Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) codes that should not be reported together for a variety of reasons. The purpose of the PTP edits is to prevent improper payments when incorrect code combinations are reported. The edits in this dataset are active for the dates indicated within. This file should NOT be used by state Medicaid programs as their edit file. Current Procedural Terminology (CPT) codes, descriptions and other data only are copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. Applicable FARS\DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for the data contained or not contained herein.

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hcpcs, cpt codes, ncci edits
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Data Provided By
Centers for Medicare and Medicaid Services
Source Link
https://www.medicaid.gov/
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Public Domain U.S. Government
Common Core
Program Code
009:076
Bureau Code
009:00
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