DME NCCI PTP Edits Coming August 2

On August 2, NCTracks will be adding Durable Medical Equipment (DME) Procedure-to-Procedure (PTP) edits to the National Correct Coding Initiative (NCCI) edits used in claims processing. The DME PTP edits were added by Centers for Medicare and Medicaid Services (CMS) to NCCI editing effective with the fourth quarter 2012 and are included in each quarterly update issued by CMS. PTP edits for DME define pairs of Healthcare Common Procedure Coding System / Current Procedural Technology (HCPCS/CPT) codes that should not be reported together. DME claims failing the PTP edits will deny and post EOB 49270 – NCCI EDIT on the provider’s paper Remittance Advice (RA.)

This edit change is effective upon implementation August 2. No claims reprocessing will be performed.