American Health Information Management Association (AHIMA) Certification Practice Exam

Which coding initiative aims to control improper coding practices in healthcare?

1. Prospective Payment System

2. Comprehensive Care Initiative

3. National Correct Coding Initiative

4. External Coding Systems

The correct answer is: National Correct Coding Initiative

The National Correct Coding Initiative (NCCI) is designed specifically to reduce improper coding practices in healthcare. This initiative was developed by the Centers for Medicare & Medicaid Services (CMS) to promote appropriate coding and to ensure that claims submitted are consistent with legislative requirements and current medical standards. The NCCI includes a set of coding edits that help prevent billing for services that should not occur together. For instance, it identifies procedures that are mutually exclusive or that should not be billed together under typical circumstances. By implementing these edits, the initiative not only aims to prevent fraudulent billing practices but also to promote accurate and effective patient care. In contrast to the other options, the Prospective Payment System primarily relates to reimbursement methods rather than coding practices directly. The Comprehensive Care Initiative encompasses various strategies to improve care delivery but does not focus solely on coding accuracy. External Coding Systems refer to coding classifications like ICD-10 or CPT, which are not initiatives aimed at controlling coding practices directly. Thus, the NCCI stands out as the key initiative specifically targeting the integrity of coding in healthcare practices.