National Correct Coding Initiative: CMS spoke softly and made big, unscheduled changes to NCCI edits

Why This Topic Matters

The article highlights a CMS update that changed NCCI edit files outside the usual fanfare, with implications for claim editing, telehealth-related services, and potential denials during the early COVID-19 response period.

Article Sections

1. April 2020 NCCI replacement files

   Introduces the CMS replacement files released in early April 2020 and describes the broad scope of the NCCI file changes.

2. COVID-19-related MUE changes

   Summarizes the temporary and deleted medically unlikely edit changes connected to telehealth and other communications-based services during the public health emergency.

3. Deleted PTP edits and impacted services

   Notes the categories of procedure-to-procedure edits affected and points readers to the article’s supporting spreadsheet for review.

4. Timing mismatch and potential claim issues

   Raises the issue of differing effective dates for COVID-19 changes and the April NCCI update, including possible implications for claims handling.