tci Medicare Compliance & Reimbursement - 2023 Issue Q4

Reader Questions: Reach Out to MACs for Claims-Based NCCI Quandaries

Question: Which agency is most appropriate to contact if I have questions about an appeal related to a National Correct Coding Initiative (NCCI) claim denial? 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 the MACs as part...

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