What are NCCI edits?
In 1994, the Health Care Financing Administration (HCFA) awarded a contract to AdminaStar Federal, the Indiana Medicare carrier, to define correct coding practices that would serve as the basis for national Medicare. In January 1996, CMS implemented the National Correct Coding Initiative (NCCI or sometimes just CCI). This initiative was developed to promote correct coding of health care services by providers for Medicare beneficiaries and to prevent Medicare payment for improperly coded services. CCI consists of automated edits provided to Medicare contractors to evaluate claim submissions when a provider bills more than one service for the same Medicare beneficiary on the same date of service. NCCI identifies pairs of services that under Medicare coding/payment policy a physician ordinarily should not bill for the same patient on the same day.
