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National Correct Coding Initiative (NCCI) Edits Change for Medicaid Expansion – July 1, 2022

Blue Cross Blue Shield of North Dakota (BCBSND) has moved our Medicaid Expansion line of business only to the Medicaid National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) and medically unlikely edits (MUE) edits effective for date(s) of service (DOS) on or after July 1, 2022. Medicaid Expansion claims with DOS prior to July 1, 2022, will continue to process against Medicare NCCI edits.

More information can be found on the Medicaid National Correct Coding Initiative website, including information on:

  • Medicaid NCCI Edit Files
  • Medicaid NCCI Manual
  • Technical Guidance Manual
  • NCCI Correspondence Language Manual
  • Centers for Medicare & Medicaid (CMS)
  • Medicare Learning Network (MLN) Booklet Resource – “How to use the Medicaid NCCI tools”

The Medicaid Expansion correct coding guidelines policy to publish on our Correct Coding Guidelines - Medicaid Expansion | BCBSND webpage.

For additional information or questions, contact our BCBSND Medicaid Expansion Customer Contact Center at 1-833-777-5779 or email prov.partners@bcbsnd.com.