Blue Cross Blue Shield of North Dakota (BCBSND) follows CMS’ Medicare and Medicaid NCCI Facility Procedure to Procedure (PTP), Medically Unlikely Edits (MUE) files and the Outpatient Code Editor (IOCE) NCCI Quarterly Data files. BCBSND implements quarterly file update through the Optum & 3M quarterly scheduled edit release.
The 3M Quarterly Files were implemented into the Facility Code editing on September 26, 2024, with an effective date of October 1, 2024. The Optum Quarterly Files were implemented into the Facility Code editing on September 27, 2024, with an effective date of October 1, 2024.
Please refer to either Correct Coding Guideline - Commercial or Correct Coding Guidelines - Medicaid Expansion for more information.
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