decisionhealth Newsletters, Part B News - 2020 Issue 9 (September)
Next NCCI edit update will revive thousands of code pairs, reset MUEs
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Article Overview
This article explains an upcoming CMS National Correct Coding Initiative (NCCI) update and what it means for practices that bill evaluation and management, anesthesia, procedure, online visit, and telephone service claims. It is aimed at coders, billers, compliance staff, and practice managers who need a high-level understanding of which edit categories are changing and what broader public health emergency flexibilities may continue. The article also touches on related CMS and HHS OCR policy considerations tied to telehealth operations.
Why This Topic Matters
Quarterly NCCI and MUE changes can affect claim edits, unit limits, and denial patterns across multiple service types. Practices need to know which categories are being restored or revised so they can update internal workflows and prepare staff for claim processing changes.
Article Sections
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NCCI quarterly update overview
A summary of the upcoming CMS update and the types of NCCI changes included. The section frames the broader context of post-PHE edit revisions.
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Highlights affecting practices
An overview of the major edit categories most likely to affect everyday billing operations. The section points to anesthesia, procedure, and online visit edit activity.
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MUEs back at full strength
A discussion of the medical unlikely edit changes included in the update. The section covers restored unit limits and related effects on common E/M services.
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What to tell your staff
Guidance-oriented background on operational awareness and related policy considerations. The section notes other emergency-era flexibilities and telehealth administration topics.
What You Will Learn
- How CMS is changing the scope of a quarterly NCCI update
- Which broad categories of services are affected by the edit revisions
- How the update relates to MUE changes for common services
- What operational areas practices should review before the update takes effect
- How the article connects NCCI changes with broader telehealth and emergency-era policy issues
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Revenue cycle teams
- Physician office staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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