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MIR-2006-10AB, October 2006
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 12.3, Effective October 1, 2006
Provider Types Affected
Physicians billing Medicare carriers
Background
This article and related CR 5258 provide a reminder for physicians to take note of the quarterly updates to the coding initiatives. The next round of CCI edits will be effective on October 1, 2006. Physicians may view the current CCI edits and the current Mutually Exclusive Code (MEC) edits at http://www.cms.hhs.gov/NationalCorrectCodInitEd/  on the Centers for Medicare & Medicaid Services (CMS) Web site. The Web site will be updated with the Version 12.3 edits as soon as they are effective.
Key Points
The National Correct Coding Initiative developed by CMS helps promote national correct coding methodologies and controls improper coding. The coding policies developed are based on coding conventions defined in the American Medical Association’s Current Procedural Terminology(CPT) manual, national and local policies and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practice, and review of current coding practice. The latest package of CCI edits, Version 12.3, is effective on October 1, 2006. This version will include all previous versions and updates from January 1, 1996 to the present and will be organized in two tables:
- Column 1/Column 2 Correct Coding Edits table; and
- MEC Edits table.
Implementation
The implementation date for this instruction is October 2, 2006.
Additional Information
The CCI and MEC file formats will be maintained in the Medicare Claims Processing Manual (Publication 100-04), Chapter 23, Section 20.9, which can be found at http://www.cms.hhs.gov/Manuals/IOM/list.asp#TopOfPage on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
MLN Matters Number: MM5258
Pub. 100-4, Transmittal# R1056CP, CR# 5258
Related CR Release Date: September 15, 2006
Effective Date: October 1, 2006
Implementation Date: October 2, 2006
Attention Physicians!
Effective October 1, 2006, Medicare will only generate the Health Insurance Portability and Accountability Act (HIPAA)-compliant remittance advice – transaction 835 version 004010A1 – to all electronic remittance advice receivers. For more details, see MLN Matters article SE0656 at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0656.pdf.
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