Miscellaneous Coding and Payment Policy Activities

The National Correct Coding Initiative (CCI)
The NCCI project is managed by an independent government contractor, the National Correct Coding Institute (NCCI). NCCI edits deals with what services should be bundled into or excluded from the intraoperative component of surgical procedures. Medicare and other payers use NCCI project edits.

NCCI Edits are updated throughout the year. To see the list of edits, visit the CMS website

Medically Unlikely Edits (MUE)
The MUE project is also managed by the NCCI and Medicare. Payers may also use MUE edits. The MUE for a CPT code is the maximum units of service under most circumstances that a provider would report for that code for a single beneficiary on a single date of service.

As with NCCI Edits, Medically Unlikely Edits are also updated throughout the year. Visit the CMS website to view the current MUEs for the various CPT codes.

International Classification of Disease (ICD) Codes
The International Classification of Disease, Ninth Edition, Clinical Modification is based on the World Health Organization ICD-9. The U.S. National Committee on Vital and Health Statistics (NCHS) has modified ICD to reflect the use of diagnostic codes used in the United States by hospital and medical providers. In 1989 the Health Care Financing Administration (now called the Center of Medicare and Medicaid Services [CMS]) designated ICD-9-CM as the diagnostic coding system physicians must use in conjunction with CPT codes.