Physicians can take advantage of a new Medicare tool to sort through the thousands upon thousands of service codes that can be bundled together for claims payment – and avoid improper billing.
The Centers for Medicare & Medicaid Services (CMS) recently released the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) lookup tool to promote accurate code-bundling and prevent improper payment of Medicare Part B and Medicaid claims when incorrect code combinations are reported. The resource is meant to help ensure components of services made to the same patient, on the same date of service, by the same physician aren’t paid for twice.
Available via Texas’ Medicare contractor Novitas Solutions, the tool is further designed to help physicians identify when certain pairs of codes are subject to automated edits.
For more information, check out these resources:
- CMS publishes a quarterly updated list of codes on its website documenting the prohibited/acceptable code combination pairs.
- CMS also posts quarterly updates to PTP edits.
- Novitas Solutions has its own webpage on the NCCI initiative.
- The Texas Medical Association offers a comprehensive NCCI education sheet and other resources to help you submit claims accurately.
Last Updated On
February 15, 2023
Originally Published On
February 15, 2023
Alisa Pierce
Reporter, Division of Communications and Marketing
(512) 370-1469