Updates to Correct Coding Initiative (CCI) Edits Now Available

The latest package of CCI edits, Version 13.3, effective October 1, 2007, and the current Mutually Exclusive Code (MEC) edits will be available at http://www.cms.hhs.gov/NationalCorrectCodInitEd/  on the Centers for Medicare & Medicaid Services (CMS) Web site. 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 (AMA’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 13.3, includes 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, and Mutually Exclusive Code (MEC) Edits. 

The CCI and MEC file formats will be maintained in the Medicare Claims Processing Manual (Chapter 23, Section 20.9) which can be found at http://www.cms.hhs.gov/Manuals/IOM/list.asp#TopOfPage

The official instruction, CR 5703, issued to your carrier and A/B MAC regarding this change may be viewed at http://www.cms.hhs.gov/Transmittals/downloads/R1330CP.pdf .