A coding manager finds the clinic’s encoder still using last year’s NCCI PTP file after a new quarter begins. What is the correct operational response?
Select an answer to reveal the explanation.
Short Explanation
NCCI is a living list, not a dusty binder. When the new quarter drops, swap in the current file—old edits can miss new bundles or wrongly block clean pairs.
Full Explanation
CMS updates NCCI PTP and MUE files on a periodic (typically quarterly) schedule. Physician practices must apply the edit version effective for the date of service. Stale encoder tables create both overcoding and undercoding risk. Commercial payers may adopt CMS edits or their own variants, but relying on outdated CMS files is not an acceptable control.