The Patient Protection and Affordable Care
Act (PPACA) mandates that all claims submitted on or after October 1, 2010, must
be filed in accordance with the Centers for Medicare & Medicaid Services (CMS)
National Correct Coding Initiative (NCCI) guidelines.
NCCI was developed to promote the correct coding of health-care
services. NCCI consists of procedure-to-procedure (PTP) edits that define pairs
of procedure codes that should not be reported together, and Medically Unlikely
Edits (MUEs) that define the maximum units of service applicable for each
procedure code per client per date of service.
Providers can refer to the CMS Medicaid website,
The National Correct Coding Initiative in Medicaid, for additional
This web page was created to provide
updates as TMHP implements the new guidelines. A link to the CMS website is also
available. Providers are encouraged to refer to the TMHP website regularly for
the most up-to-date information.