National Correct Coding Initiative (NCCI)
The Center for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payments in Medicare Part B claims.
The purpose of the NCCI edits is to prevent improper payments when incorrect code combinations are reported.
The NCCI consists of coding policies and edits. Providers report procedures and services performed on clients utilizing Healthcare Common Procedure Coding System (HCPCS) codes. These codes are submitted on claim forms to Fiscal Agents for payment. NCCI policies and edits identify procedures and services performed by the same provider for the same client on the same date of service.
The NCCI was originally implemented in the Medicare program in January 1996 to ensure accurate coding and reporting of services by physicians. The coding policies of NCCI are based on coding conventions defined in the American Medical Association’s (AMA) Current Procedural Terminology (CPT) Manual, national and local Medicare policies and edits, coding guidelines developed by National societies, standard medical and surgical practice, and/or current coding practice.
For more information, including NCCI and MUE edits, please refer to the National Correct Coding Initiative in Medicaid Web site.