Hospital OPPS NCCI Edits
Download Sample File
Improve reporting accuracy with edits for outpatient hospital claims — quarterly updates available!
Increase reporting accuracy by incorporating the National Correct Coding Initiative (NCCI) rules from these data files into your coding/billing systems. With easy access to column 1/column 2 procedure-to-procedure (PTP) edits, you’ll ensure outpatient hospital claims comply with Medicare OPPS NCCI edits.
And because CMS updates NCCI edits four times annually, you can opt to get quarterly updates to keep your claims compliant throughout the year.
Benefits of Hospital OPPS NCCI Edits Data Files
- Promote coding that complies with Medicare NCCI edit tables for outpatient facility services
- Decrease denials and prevent improper payments by adhering to PTP edits
- Save time by using the single, searchable NCCI policy manual file included
- Use modifier indicator data to know when you have the option to override an edit
- Integrate files easily with your existing coding/billing systems or third-party software
- Choose to include updates so you’re ready for January, April, July, and October changes
Features of Hospital OPPS NCCI Edits Data Files
- Medicare procedure-to-procedure correct coding edits for OPPS
- Effective date and deletion date (if applicable)
- NCCI edit policy/rationale
- NCCI modifier indicator
- NCCI policy manual
- README file with helpful information for your team
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