NCCI Edits

With the transition to our new claims processing platform, Blue Cross Blue Shield of North Dakota (BCBSND) has begun following NCCI edits (National Correct Coding Initiative). Providers may notice that code combinations they previously billed, will now deny as inclusive to another service or line as a result of this. Prior to contacting Provider Service, we would encourage providers to verify their coding against NCCI edits via the following:

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html 

Providers must review for correct coding and if the criteria are met for eligibility to bill the code combination, a replacement claim must be submitted.

Providers may review the BCBSND Reimbursement Policy for Correct Coding Guidelines on the BCBSND website.