What is the National Correct Coding Initiative?

The National Correct Coding Initiative (NCCI) is a program developed by Medicare to prevent improper payment for healthcare services. It consists of coding policies and edit systems that identify inappropriate code combinations, unbundling of services, and other coding irregularities that could lead to improper billing and payment.

Why is the National Correct Coding Initiative important?

• Payment accuracy: Prevents improper payments for unbundled or incompatible services.
• Coding standardization: Promotes consistent, appropriate coding practices.
• Fraud prevention: Reduces coding manipulation designed to increase reimbursement.

Key components of the NCCI

• Procedure-to-procedure edit tables identifying inappropriate code pairs.
• Medically Unlikely Edits (MUEs) setting limits on units of service.
• Coding policy manual providing rationale and guidelines for edits.

How Solace can help

A Solace advocate can help review your medical bills to ensure proper coding and bundling of services, identify potential coding errors that might affect your financial responsibility, and help address improper claim denials related to NCCI edits. They can also help you understand which services should be included together under a single code rather than billed separately.