Why did the Centers for Medicare and Medicaid Services implement the National Correct Coding Initiative in 1996 ?

What do your text materials say?

After 2 hours I still am having trouble with this question...

http://www.google.com/search?aq=f&sourceid=chrome&ie=UTF-8&q=National+Correct+Coding+Initiative#hl=en&expIds=17259,17315,23628,23670,23756,23945,24692,24878,24879,25646,26473,26761,26849,26869,27126,27400,27520,27613,27642,27697,27740,27743&sugexp=ldymls&xhr=t&q=National+Correct+Coding+Initiative+1996&cp=39&qe=TmF0aW9uYWwgQ29ycmVjdCBDb2RpbmcgSW5pdGlhdGl2ZSAxOTk2&qesig=cSow-9O8BoQbJwx7bjGN_A&pkc=AFgZ2tlj2-wu_zO8yeHW1uqYT3iq1jBsD5WGWoh4ExwHp3RPjiFTd8JzBoVhvSwU1cQphNbbaYuQhIcJHMeFS5dQzPwA7zsN-w&pf=p&sclient=psy&aq=f&aqi=&aql=&oq=&gs_rfai=&pbx=1&fp=a9a4c364e3bd645b

Read carefully -- especially the first article linked.

The Centers for Medicare and Medicaid Services (CMS) implemented the National Correct Coding Initiative (NCCI) in 1996 to address issues related to improper coding and billing practices in the medical field. The NCCI is a set of coding policies and edits that aim to promote accurate and consistent coding for healthcare services.

To understand why CMS implemented the NCCI, we need to look at the context and specific challenges faced at that time. Before the NCCI, there was a lack of standardized coding guidelines and edits, which led to inconsistent coding practices and errors in billing Medicare and Medicaid claims. These errors resulted in overpayments, underpayments, or inappropriate payments for healthcare services. Furthermore, incorrect coding also affected the quality of data used for research, policy-making, and healthcare management.

To address these issues and improve claims processing, CMS introduced the NCCI. The NCCI includes coding guidelines, mutually exclusive code edits, and procedure-to-procedure edits. These guidelines provide specific instructions on how to accurately code and bill for medical services. The edits prevent certain combinations of procedures from being billed together unless specific criteria are met, ensuring that billing is appropriate and accurate.

By implementing the NCCI, CMS aimed to reduce errors in coding and billing, promote appropriate payment for services, and ensure consistency in coding across healthcare providers. The NCCI not only helps prevent fraud and abuse but also enhances the integrity and financial sustainability of the Medicare and Medicaid programs.

In summary, CMS implemented the National Correct Coding Initiative in 1996 to address issues related to improper coding and billing practices, reduce errors, promote accurate payment for services, and ensure consistency in coding across healthcare providers.