The National Correct Coding Initiative (NCCI) Edits identify pairs of services that normally should not be billed by the same physician for the same patient on the same date of service. The NCCI Edits were developed for use by the Centers for Medicare and Medicaid Services (CMS) in adjudicating Medicare claims, but they also are used by many private payers and Medicaid agencies. In addition, the NCCI Edits frequently form the basis for proprietary claims software.

NCCI Edits contain 1 of 2 types of edits: Mutually Exclusive Edits and Correct Coding Edits (formerly referred to as Comprehensive/Component Edits).

Each NCCI code pair is designated with a superscript 0 (zero), 1, or 9. A superscript 0 (zero) appended to a code pair indicates that under no circumstances may a modifier be used to override that edit. Conversely, a superscript 1 appended to a code pair indicates that an appropriate modifier may...

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