Sunday, September 8, 2019

National Correct Coding Initiative Edit Essay Example | Topics and Well Written Essays - 750 words

National Correct Coding Initiative Edit - Essay Example The NCCI Coding Policy Manual for the Medicare Services is usually updated annually by the CMS. This Coding Policy Manual should therefore be used as a general reference tool, which explains the rationale for the NCCI edits, by the FIs and the carriers (â€Å"National Correct Coding Initiative Edits†, n.d.). There are two types of NCCI Edits, which include procedure-to-procedure (PTP), and Medically Unlikely Edits (MUE). The PTP edits defines HCPCS/CPT codes which should not be reported together for various reasons, while MUE defines the maximum units of service which a provider would report on the circumstances of the same beneficiary on a single service date for each HCPCS/CPT code The NCCI edits is aimed at preventing inappropriate or improper payments after reporting of incorrect code combination. It contains two tables of edits, one for the outpatient hospital services and another for the physicians/practitioners. The Correct Coding Edits table for Column 1 – Column 2 has been combined into one table with the Mutually Exclusive Edits table and they include the code pairs, which should not be reported together for several reasons, which are explained in the Coding Policy Manual (â€Å"National Correct Coding Initiative Edits†, n.d.). A Correspondence Language Manual has also been made available. It was written and is maintained for the Medical Contractors utilization in answering routine correspondence enquiries on the MUE edits and NCCI procedure-to-procedure. The rationale for the edits are explained in the paragraphs for the general correspondence language (â€Å"The National Correct Coding Initiative in Medicaid | Medicaid.gov.†, n.d .). These guidelines consist of HCPCS or CPT procedure code-pairs, which must not be reported together. It also consists of MUEs, which determine if the procedure codes are submitted in,

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