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The Center for Medicare and Medicaid Services requires all Medicare claims to be processed against the National Correct Coding Edits to promote accurate coding.
The health system reform law required that Medicaid also implement the national Correct Coding Initiative (NCCI) edits. Texas Medicaid implemented the change last fall. All Medicaid claims submitted on or after October 1, 2010 are subject to NCCI edits. The edits tell you when two procedures can be reported together and when they cannot. For example, cutting through lesions during surgery is part of the surgery and not a separate payable service.
TMA's Payment Advocacy staff has prepared a free presentation to refresh physicians’ understanding of how the Medicare NCCI process works, impart the importance of billing according to the NCCI edits, including tips for ensuring your practice stays current with NCCI changes, explain the differences between the Medicare, Medicaid, and commercial edits, and provide other helpful billing tips.
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Last Updated On
May 13, 2016
Originally Published On
March 23, 2010