- Ophthalmology and Optometry Billing Guide
- General Information
- Provider Qualifications
- Local Coverage Determinations
- National Coverage Determinations
- Limitation of Liability (Advance Beneficiary Notice)
- Modifier Usage
- Glaucoma Screening ‒ Preventive Services Coverage
- National Correct Coding Initiative
- Related Content
- Micro-invasive Glaucoma Surgery Update
The National Correct Coding Initiative
The purpose of the NCCI Procedure-to-Procedure (PTP) edits is to prevent improper payment when incorrect code combinations are reported. The NCCI contains one table of edits for physicians/practitioners and one table of edits for outpatient hospital services. The Column One/Column Two Correct Coding Edits table and the Mutually Exclusive Edits table have been combined into one table and include PTP code pairs that should not be reported together for a number of reasons explained in the Coding Policy Manual. The purpose of the NCCI MUE program is to prevent improper payments when services are reported with incorrect units of service.
Practitioners will utilize the Procedure to Procedure (PTP) edit table and hospitals will utilize the hospital PTP edit table.
Reviewed 10/13/2023