Attention Providers of Sections 31 Federally Qualified Health Center (FQHC) Services and 103 Rural Health Clinic (RHC) Services: National Correct Coding Initiative (NCCI) Change of Edit 6075 from Warn to Deny, CR 106771 and 108825

Apr 12, 2022

We have implemented a system change, in accordance with federal guidance, to opt out of applying Procedure to Procedure (PTP) NCCI edits to claims for FQHCs and RHCs. Claim lines will no longer deny due to these edits. An e-message from December 30, 2021 originally described this issue.

As a reminder, the edit that posts on claims submitted with a T1015 service code and no paid encounter service(s) will deny the T1015 claim line.  An e-message from August 12, 2021 describes this edit.

If you have questions, please contact Tia Bolduc by email or phone at (207) 624-6938