NCCI for Medicare | CMS

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for MedicarePages in this sectionNational Correct Coding Initiative (NCCI) editsMedicare NCCI Policy ManualMedicare Correspondence Language ManualMedicare NCCI Add-on Code EditsMedicare NCCI FAQ LibraryMedicare NCCI Medically Unlikely Edit (MUE) ArchiveMedicare NCCI Medically Unlikely Edits (MUEs)Medicare NCCI Procedure to Procedure (PTP) EditsAnnouncementsCMS is withdrawing NCCI PTP edits between Column One codes 80305, 80306, and 80307 for presumptive test(s), and Column Two codes G0480  G0483, and G0659 for definitive test(s).CMS will delete the edits with a replacement file for the 4th quarter of 2023. Any claim that was affected by the procedure-to-procedure edits, including those that did not apply an NCCI modifier, will be processed and paid as appropriate under existing payment and coverage policies. CMS posted areplacement fileon the NCCI PTP webpage.CMS will delete NCCI PTP edits between Column One codes22630, 22632, 22633 and 22634, and Column Two codes63052 and 63053. More information may be found on this pageunderReplacement Files.Effective Jan. 1, 2022, CMS implemented a new format for the Add-on Code (AOC) edit file. The format is a fixed-width text file. Review the newMedicare Add-On Code File Structure (PDF).The most recent edit files, including quarterly version update changes, are available on thePTP Coding Edit page, theMedically Unlikely Edits page, and theAdd-On Code Edits page.Medicare NCCI Manuals