MedicaidBilling CodesHigh impact
DHMH Compliance with National Correct Coding Initiative Edits
Maryland Medicaid·MD·Physicians
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is implementing compliance with National Correct Coding Initiative (NCCI) edits, which will automatically deny or bundle certain procedure code combinations that violate coding guidelines. This affects how physicians can bill multiple procedures together and may require modifier usage to override edits when clinically appropriate.
Action Required
Immediately: Billing team must review the NCCI edit policy document at the provided URL to identify specific code combinations that will be bundled or denied. Update billing software to flag NCCI edit violations and train staff on proper modifier usage (such as -59, -XE, -XP, -XS, -XU) to override edits when procedures are distinct and separately reportable. Review recent claim denials for NCCI violations and resubmit with appropriate modifiers if clinically justified.