NCCI Resources

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CMS originally developed the Medically Unlikely Edit (MUE) program to reduce the paid claims error rate for Part B claims. The first edits were implemented January 1, 2007. Subsequently there have been quarterly updates increasing the number of edits. Visit the NCCI main page on the CMS site.

National Correct Coding Initiative Policy Manual for Medicare Services can be accessed here: https://www.cms.gov/medicare/national-correct-coding-initiative-edits/ncci-policy-manual-medicare
A revised annual version of the National Correct Coding Initiative Policy Manual for Medicare Services effective January 1, 2021, was posted December 18, 2020.

Quarterly updates are posted here.

Find CMS’s MUE FAQs HERE.


FREE Downloads from CMS

FY2021

 

FY2020

ARCHIVES: https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Manual-Archive


more useful links for providers below:


How to Use The National Correct Coding Initiative (NCCI) Tools [PDF, 2MB]

Medicare Claim Review Programs Booklet on MR, NCCI Edits, MUEs, CERT, and RAC (PDF, 14 pgs, 1.73 MB)

MLN Matters Number: MM5402 – Medically Unlikely Edits (MUEs) Announcement, January 2, 2007 (PDF, 2 pgs, 78 KB)

Letter Announcing Publication of MUEs, dated September 18, 2008 (PDF, 2 pgs, 51 KB)

Transmittal 1386: Quarterly Update to CCI Edits, Version 14.0, Effective 01/01/2008 (also referred to as Change Request 5824) (PDF, 5 pgs, 154 KB)

MLN Matters Number: MM5824 – Qtrly Update, v14.0, Effective 01/01/2008 (PDF, 2 pgs, 72 KB)

NCCI Policy Manual for Medicare Services – Effective 1/1/2015 (zip file of 15 documents)
NCCI Policy Manual for Medicare Services – Effective 1/1/2014 (zip file of 15 documents)

NCCI Policy Manual for Medicare Services – Updated 10/1/10 (PDF as ZIP file, 551kb)
NCCI Policy Manual for Medicare Services – Updated 4/9/09 (PDF as ZIP file, 444 KB)

Chapter 23 – Fee Schedule Administration and Coding Requirements [PDF, 1MB]

Correspondence Language Manual for Medicare Services – Effective April 1, 2014 [PDF, 197KB]

Modifier 59 Article: Proper Usage Regarding Distinct Procedural Service – Updated 10/28/14 [PDF, 130KB]

Medicaid NCCI File Names and Formats

 

 

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