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July 27, 2021
SCAI Advises CMS NCCI Procedure-to-Procedure Edits Take Effect October 1
July 27, 2021—The Society for Cardiovascular Angiography & Interventions (SCAI) advised that the Centers for Medicare & Medicaid Services (CMS) has published the “Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.3, Effective October 1, 2021.”
SCAI refers readers to the CMS MLN Matters newsletter on the Quarterly Update, available online here, which is addressed to physicians, providers, and suppliers billing Medicare Administrative Contractors (MACs) for services provided to Medicare patients.
As noted in the MLN Matters summary, CMS developed the NCCI to promote national correct coding methodologies and control improper coding that leads to inappropriate payment in Part B claims. Version 27.3 will include all previous versions and updates from January 1, 1996, to the present. The effective date is listed as October 1, and the implementation date is October 4, 2021.
Change Request 12340, which was issued to MACs as the official instruction for this change, is available online here. The CMS PTP Coding Edits can be reviewed here, and additional information is available on the CMS NCCI webpage, here.
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