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Minnesota National Correct Coding Initiative (NCCI)

The Centers for Medicare & Medicaid Services (CMS) implemented the National Correct Coding Initiative (NCCI or CCI) to promote national correct coding methodologies and control improper coding that leads to inappropriate payments. NCCI consists of code pair edits and medically unlikely edits (MUEs). 

  • CCI procedure-to-procedure code pair edits define pairs of Healthcare Common Procedure Coding System (HCPCS) codes (Current Procedural Terminology (CPT) and HCPCS Level II) that should not be reported together except under certain circumstances. The edits are applied to services billed by the same provider for the same patient for the same date of service.
  • MUEs are unit-of-service edits that define for each HCPCS code, the maximum likely, medically reasonable and necessary number of units of service that would be reported for the vast majority of appropriately reported claims. MUEs are applied to each line of service as rendered by a single provider or supplier to a single patient on the same date of service.
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