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MedicaidBilling CodesMedium impact

Medicaid Management Information System Updated with NCCI Quarter 3 2024 Files

Nevada Medicaid·NV·Billing & Coding
Effective date
Jul 1, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Nevada Medicaid has updated their system with new National Correct Coding Initiative (NCCI) edits for Quarter 3 2024, which will affect how procedure code combinations are processed and validated. The system will now use updated Medically Unlikely Edits (MUE) and Procedure-to-Procedure (PTP) edits to prevent improper payments when incorrect code combinations are reported.

Action Required

Action needed
By July 1, 2024: Billing team must ensure all procedure codes are billed with correct modifier combinations and verify code combinations comply with updated NCCI edits. Review CMS NCCI website at https://www.medicaid.gov/medicaid/program-integrity/ncci/index.html for specific edit details. Claims with incorrect code combinations or exceeding MUE limits will be denied.