CMS developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Part B claims. CMS developed its coding policies based on coding conventions defined in the American Medical Association's (AMA) 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. CMS annually updates the National Correct Coding Initiative Coding Policy Manual for Medicare Services and may make updates to individual edits quarterly. The Coding Policy Manual should be utilized by carriers and providers as a general reference tool that explains the rationale for NCCI edits.
Any claim processed by Iowa Medicaid where a correct coding edit posts has supplemental edit details available on this portal:
Access to the edit detail is as simple as clicking the link and entering the Transaction Control Number (TCN) and billing NPI of the claim.
Informational Letters Concerning CCI:
- #875 - Implementation of Correct Coding Initiative and Compliance with CPT, AMA, and National Coding Guidelines Retrospective and Prospective Review of Claims
- #882 - Modifier and Payment Policy Updates
- #912 - Implementation of National Correct Coding Initiative and Compliance with CPT, AMA, and National Coding Guidelines
- #933 - OB Billing Guidelines for Correct Coding Initiative
- #940 - Implementation of Local Coverage Determinations (LCD) and Medicare Medically Unlikely Edits (MUE) Editing
- #941 - Implementation of National Correct Coding Initiative (NCCI) and Compliance with CPT, AMA, and National Coding Guidelines
- #944 - Properly Declaring Units of Service for a Given Date
- #955 - TCM - Properly Declaring Units of Service for a Given Date
- #956 - Billing Multiple Units
- #966 - Duplicate Claim Submissions
Links to Tools and Resources: