MedicaidBilling CodesMedium impact
Medicaid Management Information System Updated with NCCI Quarter 1 2025 Files
Nevada Medicaid·NV·Billing & Coding
Effective date
Jan 1, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated its system with new NCCI Quarter 1 2025 files that include updated Medically Unlikely Edits (MUE) and Procedure-to-Procedure (PTP) edits. These edits will affect claim processing by preventing improper payments when incorrect code combinations are reported or service limitations are exceeded.
Action Required
By January 1, 2025: Billing team must review and verify all procedure code combinations and modifier usage for Nevada Medicaid claims to ensure compliance with updated NCCI edits. Check CMS NCCI website for specific edit details and update billing practices to avoid claim denials due to incorrect code combinations or exceeded service limits.