National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits prevent inappropriate payment of services that should not be reported together. Each edit has a Column One and Column Two HCPCS/CPT code. If a provider reports the two codes of an edit pair for the same beneficiary on the same date of service, the Column One code is eligible for payment, but the Column Two code is denied unless a clinically appropriate NCCI PTP-associated modifier is also reported.
Quarterly Version Update Changes
CMS posts changes to each of its NCCI PTP published edit files on a quarterly basis. This includes additions, deletions, and modifier indicator quarterly changes to PTP column one/column two correct coding edits and the PTP mutually exclusive code edits for Practitioners and Hospital Outpatient PPS in the Outpatient Code Editor.
Related Downloads
2024 Quarter 2 Edit Files:
Hospital PTP Edits
- Hospital PTP Edits v301r0 (445,017 Records) 0001A/0591T -- 24305/G0471 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
- Hospital PTP Edits v301r0 (445,072 Records) 24310/0213T -- 36005/G0471 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
- Hospital PTP Edits v301r0 (445,134 Records) 36010/0213T -- 61323/G0471 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
- Hospital PTP Edits v301r0 (439,773 Records) 61330/0082T -- U0003/U0004 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
Practitioner PTP Edits
- Practitioner PTP Edits v301r0 (645,065 Records) 0001A/0591T -- 25492/G0471 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
- Practitioner PTP Edits v301r0 (645,145 Records) 25500/01810 -- 37221/J2001 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
- Practitioner PTP Edits v301r0 (644,853 Records) 37222/11000 -- 62140/G0471 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
- Practitioner PTP Edits v301r0 (610,026 Records) 62141/0213T-- U0003/U0004 (ZIP) - Effective Apr. 1, 2024; Posted Mar. 1, 2024
2024 Quarter 1 Edit Files:
Hospital PTP Edits
- Hospital PTP Edits v300r0 (445,176 Records) 0001A/0591T – 24320/G0471 (ZIP) - Effective Jan. 01, 2024; Posted Dec. 1, 2023
- Hospital PTP Edits v300r0 (444,936 Records) 24330/0213T – 36221/G0471 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
- Hospital PTP Edits v300r0 (445,037 Records) 36222/0596T – 61343/G0471 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
- Hospital PTP Edits v300r0 (437,776 Records) 61345/0213T – U0003/U0004 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
Practitioner PTP Edits
- Practitioner PTP Edits v300r0 (636,288 Records) 0001A/0591T – 25391/G0471 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
- Practitioner PTP Edits v300r0 (635,881 Records) 25392/01810 – 36833/G0471 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
- Practitioner PTP Edits v300r0 (635,917 Records) 36834/01844 – 61592/G0471 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
- Practitioner PTP Edits v300r0 (634,827 Records) 61595/0213T – U0003/U0004 (ZIP) - Effective Jan. 1, 2024; Posted Dec. 1, 2023
