NCCI Edit Updates – Effective January 1, 2025
NCCI Edit Updates – Effective January 1, 2025
Date: January 1, 2025
Category: Compliance & Coding Edits
Summary:
The January 2025 National Correct Coding Initiative (NCCI) updates have been implemented, introducing new bundling edits and modifier allowances to ensure proper claim submission and reimbursement.
Key Changes:
- New procedure-to-procedure (PTP) edits restricting incorrect code combinations
- Updated Medically Unlikely Edits (MUE) limiting unit-of-service billing errors
- Modifier guidance revisions affecting specific CPT and HCPCS codes
- Expanded bundling rules aligning with Medicare and payer reimbursement policies
Impact on Case2Code Users:
- NCCI edits now applied to relevant CPT and HCPCS codes in Case2Code.
- Modifier Assist updated to reflect the latest bundling and exception rules.
- Code search results adjusted to highlight new bundling restrictions and billing recommendations.
