Update for NCCI Edits 2016
A reminder to providers and payers alike of the changing nature to the federal bundling rules, Version 22.1 of the National Correct Coding Initiative (NCCI) will be ready for upload after the first of the year. A test file will be available approximately January 31, 2016. The final file will be posted on or about Feb. 14.
Version 22.1 includes all previous versions and update since January 1996 and it will be released in the customer Column 1/Column 2 format with both National Correct Coding Edits and Mutually Exclusive Code edits.
The Centers for Medicare & Medicaid Services (CMS) developed the National Correct
Coding Initiative (NCCI) to promote national correct coding methodologies and to control
improper coding that leads to inappropriate payment in Part B claims. The coding policies
developed are based on coding conventions defined in the American Medical Association?s
Current Procedural Terminology manual, national and local policies and edits, coding
guidelines developed by national societies, analysis of standard medical and surgical
practice, and review of current coding practice.
The latest package of CCI edits, Version 22.0, effective January 1, 2016, will be available
via the CMS Data Center (CDC). A test file will be available on or about November 2,
2015, and a final file will be available on or about November 17, 2015.
Version 22.0 will include all previous versions and updates from January 1, 1996, to the
present. In the past, CCI was organized in two tables: Column 1/Column 2 Correct Coding
Edits and Mutually Exclusive Code (MEC) Edits. In order to simplify the use of NCCI edit
files (two tables), on April 1, 2012, CMS consolidated these two edit files into the Column
One/Column Two Correct Coding edit file. Separate consolidations have occurred for the
two practitioner NCCI edit files and the two NCCI edit files used for OCE. It will only be
necessary to search the Column One/Column Two Correct Coding edit file for active or
previously deleted edits. CMS no longer publishes a Mutually Exclusive edit file on its
website for either practitioner or outpatient hospital services, since all active and deleted
edits will appear in the single Column One/Column Two Correct Coding edit file on each
website. The edits previously contained in the Mutually Exclusive edit file are NOT
being deleted but are being moved to the Column One/Column Two Correct Coding
edit file. Refer to the CMS NCCI webpage for additional information