National Correct Coding Initiative (NCCI)
The National Correct Coding Initiative (NCCI) Policy Manual for Medicaid Services is made available annually and is available on the Medicaid.gov website as is general information and announcements regarding the National Correct Coding Initiative in Medicaid.
In addition, both the Medicaid NCCI Technical Guidance Manual and Medicaid NCCI Correspondence Language Manual are available on the Medicaid NCCI Reference Documents page, specifically within the Recent NCCI Manuals area.
Past versions of the NCCI Policy Manual for Medicaid Services are available within the Archive. The Archive area is located on the Medicaid NCCI Reference Documents page at the bottom.
Click NCCI Edits for a listing of the available coding edits including each of the following:
- Procedure to Procedure (PTP) edits – NCCI PTP edits for HCPCS/CPT codes apply to services reported by the same provider/supplier for the same beneficiary on the same date of service.
Select the PTP edit links listed and based on services type (Practitioner, Outpatient Hospital, or Durable Medical Equipment).
- Medically Unlikely Edits (MUEs) – MUEs are either claim line edits or date of service edits. If the unit on the claim line exceeds the MUE value, the claim line will be denied.
- Select the MUE edit links listed and based on services type (Practitioner, Outpatient Hospital, or Durable Medical Equipment).
- NCCI Frequently Asked Questions (FAQs) – Click NCCI FAQs to view the available Frequently Asked Questions for NCCIs, which including the following information:
- Explains what and why
- Information regarding PTP edits and MUEs
- NCCI appeals
Note: : PTP and MUE tables are updated by Medicaid quarterly.