National Correct Coding Initiative (NCCI) Procedure to Procedure

The Medicare National Correct Coding Initiative (NCCI) was implemented to promote national correct coding methodologies and to control improper coding leading to inappropriate payment.

• True

• False

The Medicare National Correct Coding Initiative (NCCI) includes all possible combinations of correct coding edits or types of unbundling that exist.

• True

• False

When reviewing the current version of the National Correct Coding Initiative (NCCI) Procedure to Procedure edits it includes all previous versions and all updates from January 1, 1996 to the present.

• True

• False

The Medicare National Correct Coding Initiative (NCCI) are updated, loaded into the Medicare claims processing systems and onto the CMS web pages.

• Monthly

• Quarterly

• Bi-annually

• Annually

The Medicare National Correct Coding Initiative (NCCI) is comprised of two provider-type choices of procedure-to-procedure (PTP) code pair edits.

• True

• False

For the Medicare National Correct Coding Initiative (NCCI) edits which modifier indicator will allow a separate payment for the component service, if all criteria is met?

• Modifier Indicator – 0

• Modifier Indicator – 1

• Modifier Indicator – 9

If both the Column 1 code and the Column 2 code are clinically appropriate you must submit the claim with the medical documentation to support the Column 2 code?

• True

• False

Modifier 59 is the only valid modifier to use to justify the clinical circumstances to unbundle a code pair edit?

• True

• False

When services are denied based on an NCCI edit you can bill the beneficiary?

• True

• False

Concerns/questions about NCCI edits should be sent to:

• National Government Services

• Centers for Medicare and Medicaid Services

• Office of Inspector General

• Correct Coding Solutions LLC