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Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 12.0, Effective January 1, 2006
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MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Medlearn Matters Number: MM4168
Related Change Request (CR) #: 4168
Related CR Release Date: November 4, 2005
Effective Date: January 1, 2006
Related CR Transmittal #: 742
Implementation Date: January 3, 2006
Provider Types Affected
Physicians billing Medicare carriers
Provider Action Needed
This is 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 January 1, 2006. Physicians may view the current CCI edits and the current Mutually Exclusive Code (MEC) edits at http://www.cms.hhs.gov/physicians/cciedits  on the Centers for Medicare & Medicaid (CMS) Web site. The Web site will be updated with the Version 12.0 edits as soon as they are effective.
Background
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 12.0, is effective on January 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.
Additional Information
The CCI and MEC files will maintain the file formats 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
Medlearn Matters articles are prepared as a service to the public and are not intended to grant rights or impose obligations. Medlearn Matters articles 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.
For more information, visit the Medlearn Matters Web page at: http://www.cms.hhs.gov/MedlearnMattersArticles/.
Posted: 11/18/2005
CPT codes, descriptions, and
other data only are copyright 2005 American Medical Association
(or such other date of publication of CPT). All Rights Reserved.
Applicable FARS/DFARS Apply.
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