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<p>Pursuant to this change, MACs are required to adjust any claims denied due to the NCCI edits. This affects claims with dates of service between July 1 and October 1, 2023. Labs can also appeal the denials in lieu of waiting for the MAC adjustments.</p><p>These NCCI edits caused significant concern in the lab industry prompting NILA (the National Independent Laboratory Association) to submit a letter to CMS in August requesting that these edits be rescinded. The letter is available here: <a href="https://www.nila-usa.org/images/nila/2023/NCCILetter.pdf">NCCILetter.pdf (nila-usa.org)</a>.</p><p>Labs, please take note of your options under this rescission of the NCCI edits and make sure you are following up to obtain reimbursement for any such denied claims.</p><input type='hidden' id='passle-remote-hosting-tracking-shortcode' value='102insf'/><blockquote class="wp-block-quote passle-quote has-cite-link"><p>Effective July 1, 2023, CMS implemented NCCI PTP edits between Column One codes 80305, 80306, and 80307 for presumptive test(s), and Column Two codes G0480 – G0483, and G0659 for definitive test(s). CMS will withdraw these edits retroactive to July 1, 2023 in a replacement file for the 4th quarter of 2023.</p><cite><a href="https://www.cms.gov/ncci-medicare" aria-label="www.cms.gov/..." title="https://www.cms.gov/ncci-medicare" target="_blank">www.cms.gov/...</a></cite></blockquote><div class="passle-featured-image passle-featured-image-position-bottom"><img src="https://images.passle.net/fit-in/400x400/filters:crop(0,383,1953,1096)/Passle/5f6edd8e8cb62a0bec3e5fd2/SearchServiceImages/2023-09-14-13-46-29-978-65030eb5531d7869e90215c1.jpg" alt="Featured Image" /></div>

CMS retroactively rescinds NCCI edits for presumptive and definitive drug testing

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