|MOST COMMON QUESTIONS WITH CORRECTLY
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NCCI - National correct coding initiative
CCI - Also known as National correct coding initiative, correct coding initiative
NCCI - Was implemented to promote National correct coding methodologies and take
control in proper coding leading to inappropriate payment
PTP - Ncci procedure to procedure code pair edits are automated prepayment edit that
prevent improper payment when certain codes are submitted together for Part B - covered
services.
MUE's - Medically unlikely edits
MUE - Is a maximum number of units of service { UOS } allowable under certain
circumstances for a single Healthcare Common Procedure Coding System /Current Procedural
Training (HCPCS /CPT), code billed by a provider of service for a single beneficiary
HCPCS - Healthcare common procedure coding system
CPT - Common procedural training
PTP Service Denial - May not be billed to Medicare beneficiaries, a provider cannot utilize
an advance beneficiary notice of non-coverage ABN, to seek payment from a Medicare
beneficiary. The ncci tools found on the centers for Medicare and Medicaid services CMS
website including the national correct coding initiative policy manual for Medicare Services help
providers avoid coding and billing errors and subsequent payment denials.
MAC - Medicare administrative contractor, should be contacted about payment
adjustments when providers determine that claims have been coded incorrectly.
NCCI Tables - Are updated quarterly and loaded into the Medicare claims payment
processing systems and onto the CMS and CCI web pages
NCCI policy manual for Medicare services - Is updated annually