Find answers to frequently asked questions about National Correct Coding Initiative (NCCI) Methodologies in the FAQ library.
Recent NCCI Manuals
- NCCI Policy Manual for Medicaid Services, effective January 1, 2021, posted December 28, 2020
- Complete Table of Contents (PDF, 126.36 KB)
- Introduction (PDF, 156.02 KB)
- Chapter 1: General Correct Coding Policies (PDF, 282.72 KB)
- Chapter 2: Anesthesia Services (PDF, 215.9 KB)
- Chapter 3: Surgery: Integumentary System (PDF, 199.67 KB)
- Chapter 4: Surgery: Musculoskeletal System (PDF, 188.01 KB)
- Chapter 5: Surgery: Respiratory, Cardiovascular, Hemic and Lymphatic Systems (PDF, 211.73 KB)
- Chapter 6: Surgery: Digestive System (PDF, 201.28 KB)
- Chapter 7: Surgery: Urinary, Male Genital, Female Genital, Maternity Care and Delivery Systems (PDF, 201.22 KB)
- Chapter 8: Surgery: Endocrine, Nervous, Eye and Ocular, Adnexa and Auditory Systems (PDF, 215.83 KB)
- Chapter 9: Radiology Services (PDF, 229.51 KB)
- Chapter 10: Pathology and Laboratory Services (PDF, 261.84 KB)
- Chapter 11: Medicine, Evaluation and Management Services (PDF, 299.7 KB)
- Chapter 12: Supplemental Services (PDF, 227.75 KB)
- Chapter 13: Category III Codes (PDF, 205.74 KB)
- Medicaid NCCI Technical Guidance Manual (PDF, 1.27 MB) revised January 1, 2020
- The National Correct Coding Initiative (NCCI) Program updates the Medicaid NCCI Technical Guidance Manual (TGM) annually. The TGM provides technical assistance for the states on correctly and completely implementing NCCI edits. The January 1, 2020 revision reflects the following changes.
- States are not required to report savings. States are no longer required to send NCCI deactivation requests to CMS Regional Offices.
- To assist states that would like to estimate NCCI cost savings, CMS recently developed and is posting in the Resources section of this page, the NCCI MUE and PTP Edit Savings Guidance for State
Medicaid Agencies.
- The Medicaid NCCI Technical Guidance Manual contains information previously published in the Technical Guidance Document and the Edit Design Manual.
- The National Correct Coding Initiative (NCCI) Program updates the Medicaid NCCI Technical Guidance Manual (TGM) annually. The TGM provides technical assistance for the states on correctly and completely implementing NCCI edits. The January 1, 2020 revision reflects the following changes.
- Medicaid NCCI Correspondence Language Manual (PDF, 364.42 KB) January 1, 2020
Resources
- SE1418 - Proper use of Modifier 59 revised March 2020
- NCCI MUE and PTP Edit Savings Guidance for State Medicaid Agencies (PDF, 115.78 KB) November 2019
Reports to Congress
- Annual Report to Congress on the Medicare and Medicaid Integrity Programs FY2017
- Annual Report to Congress on the Medicare and Medicaid Integrity Programs FY2015
- Annual Report to Congress on the Medicare and Medicaid Integrity Programs FY2013 and FY2014
- Report to Congress on Implementation of the NCCI in the Medicaid Program (PDF, 331.4 KB) March 2011
Archive
- Medicaid NCCI Policy Manual (ZIP, 3.68 MB) effective January 1, 2020
- Medicaid NCCI Correspondence Language Manual (PDF, 395.59 KB) April 2019
- Medicaid NCCI Policy Manual (ZIP, 1.19 MB) effective January 1, 2019
- Medicaid NCCI Correspondence Language Manual (PDF, 182.27 KB) April 2019
- Medicaid NCCI Technical Guidance Manual (PDF, 1.11 MB) October 2018
- Medicaid NCCI Policy Manual (ZIP, 829.97 KB) effective January 1, 2018
- Medicaid NCCI Policy Manual (ZIP, 802.69 KB) effective January 1, 2017
- Medicaid NCCI Policy Manual (ZIP, 845.59 KB) effective January 1, 2016
- Medicaid NCCI Policy Manual (ZIP, 732.77 KB) effective January 1, 2015
- Medicaid NCCI Policy Manual (ZIP, 715.77 KB) effective January 1, 2014
- Medicaid NCCI Policy Manual (ZIP, 688.85 KB) effective January 1, 2013
- Medicaid NCCI Policy Manual (ZIP, 643.14 KB) effective January 1, 2012
- State Medicaid Director Letter #11-003 (PDF, 159.55 KB) provided additional guidance, effective April 22, 2011
- Medicaid NCCI Policy Manual (ZIP, 527.79 KB) effective October 1, 2010