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 Dec. 27, 2024, with an effective date of Jan. 1, 2025. The Optum Quarterly Files will be implemented into the Facility Code editing by Jan. 31, 2025, with an effective date of Jan. 1, 2025.
Please refer to either Correct Coding Guideline - Commercial or Correct Coding Guidelines - Medicaid Expansion for more information.
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