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News
NCCI Implementation Planned
Recent News
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Effective October 1, 2009, Midlands Choice will implement National Correct Coding Initiative (NCCI) edits when repricing physician claims. Adjustments that result from these edits will be reported on CMS-1500 claim face sheets.
NCCI edits were developed by CMS to promote correct coding and to eliminate incorrect billing of medical services. Coding policies are based on conventions defined in the American Medical Association's CPT manual, national and local policies and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practices, and a review of current coding practices.
NCCI edits are applied to services billed by the same provider for the same patient on the same date of service when pairs of CPT or HCPCS Level II codes are submitted together, but the codes usually are not separately payable.
Providers are encouraged to review NCCI code pair listings that are published on the CMS website. The listings are available free for downloading and are updated in January, April, July and October.
