American Health Information Management Association (AHIMA) Certification Practice Exam

Which initiative was developed to promote correct coding methodologies in Medicare Part B claims?

1. Outpatient Perspective Payment System (OPPS)

2. National Correct Coding Initiative (NCCI)

3. Ambulatory Payment Classifications (APCs)

4. Comprehensive Outpatient Rehab Facilities (CORFs)

The correct answer is: National Correct Coding Initiative (NCCI)

The National Correct Coding Initiative (NCCI) was established specifically to promote the use of correct coding methodologies in Medicare Part B claims. This initiative was introduced by the Centers for Medicare & Medicaid Services (CMS) to enhance the accuracy of claims submissions and reduce improper payments by ensuring that coding is appropriate and adheres to established guidelines. NCCI encompasses comprehensive coding edits that help identify potential coding discrepancies, enabling providers to correctly bill for specific services. By ensuring proper use of modifiers and bundling certain services together, the initiative aims to prevent billing errors and promote best practices among healthcare providers. In contrast, initiatives like the Outpatient Perspective Payment System (OPPS) focus on payment methodologies for outpatient services rather than directly addressing coding accuracy. Ambulatory Payment Classifications (APCs) are related to OPPS but are also not specifically tailored to coding correctness. Comprehensive Outpatient Rehab Facilities (CORFs) pertain to specific care facilities rather than coding initiatives. Thus, the National Correct Coding Initiative stands out as the relevant program that directly addresses the promotion of accurate coding practices in Medicare Part B claims.