CMS has issued a solicitation seeking a contractor that shall be responsible for supporting the National Medicare and Medicaid Correct Coding Initiative (NCCI), a Center for Medicare and Medicaid Services (CMS) initiative to prevent improper payments and promote consistent coding for national programs. The NCCI program functions to promote program integrity and compliance through guidance, edits, and other methodologies that promote the consistent administration of CMS payment policies in instances where the manipulation of coding could lead to inappropriate, increased reimbursements.
At a minimum, the contractor shall be responsible for: maintaining Procedure to Procedure (PTP), Add-On Code (AOC) and related edits, including updating the current edits with any recommended changes or comments and incorporating Current Procedural Terminology (CPT) additions, deletions, and revisions; maintaining the Medically Unlikely Edits (MUEs) (Units-of-Service Edits) to reduce coding and clerical errors…
