tci General Surgery Coding Alert - 2023 Issue Q4

Reader Questions: Go to MACs for Claims-Based NCCI Quandaries

Question: If I have a question about appealing a claim that has been denied due to an NCCI edit, which agency is most appropriate to contact for a resolution? AAPC Forum Participant Answer: Though it may seem confusing, if you have a question about a specific claim, even if related to NCCI, you should direct it to your assigned Medicare Administrative Contractor (MAC), not an NCCI contractor. “The NCCI Contractor is able to address general questions and concerns about the NCCI program and edits. Claim-specific inquiries must be directed to the MAC because NCCI edits are implemented by...

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