The National Correct Coding Initiative (NCCI) edits, published by CMS, identify pairs of codes that should not be reported together for the same patient on the same day, and maximum units per service (MUEs).
Some pairs can be billed together with an appropriate modifier when the services were truly separate and documented as such.
Related terms
- Claim scrubbing
- Checking a claim for errors and payer rules before it is submitted.
- Modifier
- A two-character code added to a CPT or HCPCS code to give the payer more information.
- Claim denial
- A payer's decision not to pay a claim that it received and processed.