The correct coding practices for outpatient hospital claims as mandated by CMS in its NCCI files — with quarterly updates!

Decrease claim resubmission costs by incorporating the National Correct Coding Initiative (NCCI) rules from this data file into your coding/billing system to make pre-clearinghouse outpatient hospital claims inherently compliant with official Medicare CCI edits.

SuperCoder’s OPPS CCI Edits Data Files help:
  • Promote compliant CCI coding of healthcare services rendered in the outpatient facility.
  • Decrease denials from incorrectly coded outpatient claims by letting your reimbursement professional follow the rules based on these edits.
  • Prevent improper payments when your outpatient claim bills more than one service on the same date of service for the same beneficiary.
  • Access the essential compliance data incorporated in almost all payers’ coverage policies.
The data files equip your outpatient hospital reimbursement systems with unparalleled advantages:
  • A single, searchable file for the current NCCI policy manual included with your data files saves staff time hunting for applicable changes through the numerous sections of the CMS manual online.
  • Automated procedure-to-procedure pairs and procedure-to-units of service pairs identify improper outpatient hospital coding scenarios.
  • Modifier indicators let you know when you have the option to override an edit, if supported by clinical justification, in the outpatient hospital setting.
You will love OPPS CCI ready-to-go files that are:
  • Developed to save staff time from incorporating raw or delayed data by providing the data in database-friendly formats: Pipe delimited and xls.
  • Designed for your existing coding/billing systems or third party software to directly import and utilize this data from a single source without any installs.
  • Provided as early as possible the month prior (Dec - Q1, March - Q2, June - Q3, Sept - Q4) to the new version’s effective date to allow maximum time to educate staff on changes and incorporate edits on the backend.
File Types Provided
  1. Pipe ( | ) delimited .TXT file
  2. .XLS file
Available Formats
  • CD: Order ships within 10 business days from the confirmation order date
  • URL: Acquire the data set right away by downloading the data from a secure web page (internet connection required)
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