National Correct Coding Initiative (NCCI) edits are updated quarterly by the Centers for Medicare and Medicaid Services (CMS) and Capital Bridge, CMS’ NCCI coding contractor. Updates occur on January 1, April 1, July 1, and October 1 of each calendar year. Typically, the January 1 update sees the most additions, deletions and revisions due to new, revised and deleted CPT codes taking effect on January 1 of the calendar year.
Due to the COVID-19 Public Health Emergency as well as CMS’s expansion of telehealth services, CMS updated procedure-to-procedure (PTP) edits and Medically Unlikely Edits (MUEs) for Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, retroactive to January 1, 2020. This announcement was posted on April 8, 2020 on the CMS website.
There have been many significant changes (well over 150) to the PTP edits applicable to physical, occupational and speech therapy services with all of them retroactive to January 1, 2020. Many of the NCCI edits have been deleted, including those that became effective January 1, 2020.
I have updated NCCI Version 26.0 for dates of service January 1, 2020 – March 31, 2020 for both the private practice setting and non-private practice settings. In addition, NCCI Version 26.1 for dates of service April 1, 2020 – June 30, 2020 has been published on my website for my Gold Members. To access the NCCI edit reference sheet, click HERE.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.