MedicaidBilling CodesHigh impact
National Correct Coding Initiative
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Oct 1, 2010
We identified it
Jun 21, 2026
Summary
State Medicaid agencies must now apply National Correct Coding Initiative (NCCI) editing methodologies as required by the Affordable Care Act. This includes procedure-to-procedure edits that prevent inappropriate code combinations and Medically Unlikely Edits (MUEs) that limit units of service per code.
Action Required
Effective October 1, 2010: Billing team must ensure all Medicaid claims comply with NCCI editing rules including procedure-to-procedure edits and MUE unit limits. Review current billing practices for code combinations that may now be rejected. Monitor for additional guidance from CMS on specific provider types and claim types subject to NCCI editing. Contact Bureau of Comprehensive Health Services at 1-877-782-5565 for questions.