Understanding NCCI Edits and Avoiding Claim Denials

Understanding NCCI Edits and Avoiding Claim Denials

Insurance companies use different methods and policies in determining claims processing based on coding guidelines and medical necessity. CMS created the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payment. Today, multiple parts of the NCCI edits play a role in payment or denial of Medicare claims. In addition, many commercial insurance payers also have implemented these edits in their own reimbursement systems. With an understanding of the edits and how to apply them, denials can be corrected for timely reimbursement, which is critical because insurance carriers allow corrections and reconsiderations for only a specified time after the date of service or original filing date. This 90-minute webinar will discuss the NCCI edits so OMSs and their staff can apply them during billing and coding or when resolving denials.

Learning Objectives

At the conclusion of this program, participants should be able to:

1. Break down the components of the NCCI edit program.  
2. Incorporate correct coding initiatives to promote appropriate documentation and proper code selection. 
3. Apply policies and guidelines in the NCCI Policy Manual for clean claims. 

Cancellation Policy: Registrants will receive a full refund up until the day before the event. No refund will be given on the day of or after the event.

Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.

ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.5 continuing education credit(s).

AGD - Accepted Program Provider
FAGD/MAGD Credit
11/1/22-12/31/26
Provider ID# 214680

The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.