Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits
The Centers for Medicare and Medicaid Services (CMS) issued the Related Change Request (CR) Number 11628 which contains the quarterly update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits. The latest package of the NCCI PTP edits is Version 26.1 and will be implemented on April 1, 2020.
CMS developed the NCCI to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment in Part B claims. The NCCI polices are based on coding conventions defined by the American Medical Association’s Current Procedural Terminology (CPT®) manual, national and local policies/edits, national society coding guidelines, analysis of standard medical and surgical practice, and review of current coding practices.
Version 26.1 will include all previous versions and updates from January 1, 1996 to the present, organized into the Column One/Column Two Correct Coding file. All active and deleted edits will appear in this file. For additional information regarding NCCI edits, refer to the CMS NCCI webpage on the following link:
To review the entire MLN Matters Article, click on the following link:
