National Correct Coding Initiative PTP for Outpatient Hospitals

**Overview**
This data package contains the National Correct Coding Initiative (NCCI), the procedure to procedure (PTP) edits, for outpatient hospitals as well as physicians/practitioners. The quarterly additions include information about the changes/additions in the PTP edit published files for the current quarter.

**Description**
This data package contains the Centers for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B claims. The coding policies are based on coding conventions defined in the American Medical Association's Current Procedural Terminology (CPT) Manual, national and local Medicare policies and edits, coding guidelines developed by national societies, standard medical and surgical practice, and/or current coding practice. NCCI includes three types of edits: NCCI Procedure-to-Procedure (PTP) edits, Medically Unlikely Edits (MUE), and Add-on Code Edits. NCCI 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-associated modifier is also reported. The additions, deletions, and modifier indicator quarterly changes to PTP column 1/ column 2 correct coding edits and the PTP mutually exclusive code edits for Hospital Outpatient Prospective Payment System (PPS) in the Outpatient Code Editor as well as physicians/practitioners are updated on CMS website.

**Benefits**
- Useful for individuals operating within and working according to prospective payment system, healthcare professionals, healthcare providers, suppliers and medical research groups. national correct coding initiative database is available on centers for medicare & medicaid services website in raw form, whereas a john snow labs (jsl) customer gets it in a clean and normalized form ready to use and create his own custom reports. easy to comprehend for the customers who are unfamiliar with the medical terminologies as all abbreviated terms are replaced with full form, unlike centers for medicare & medicaid services (cms) original datasets which have many abbreviations. recent dataset for 2018 is available for use.

**License Information**
The use of John Snow Labs datasets is free for personal and research purposes. For commercial use please subscribe to the [Data Library](https://www.johnsnowlabs.com/marketplace/) on John Snow Labs website. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.

**Included Datasets**
- [Quarterly NCCI PTP Edits for Outpatient Hospitals](https://www.johnsnowlabs.com/marketplace/quarterly-ncci-ptp-edits-for-outpatient-hospitals)
- The National Correct Coding Initiative, the procedure to procedure (PTP) edits, for outpatient hospitals, quarterly additions contain the information about the changes/additions in the PTP edit published files for the current quarter.
- [Quarterly NCCI PTP Edits for Physicians or Practitioners](https://www.johnsnowlabs.com/marketplace/quarterly-ncci-ptp-edits-for-physicians-or-practitioners)
- The National Correct Coding Initiative, the procedure to procedure (PTP) edits, for physicians/practitioners, quarterly additions contain the information about the changes/additions or deletions in the PTP edit published files for the current quarter.

**Data Engineering Overview**
**We deliver high-quality data**
- Each dataset goes through 3 levels of quality review
- 2 Manual reviews are done by domain experts
- Then, an automated set of 60+ validations enforces every datum matches metadata & defined constraints
- Data is normalized into one unified type system
- All dates, unites, codes, currencies look the same
- All null values are normalized to the same value
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- Metadata is provided in the open Frictionless Data standard, and its every field is normalized & validated
- Data Updates
- Data updates support replace-on-update: outdated foreign keys are deprecated, not deleted

**Our data is curated and enriched by domain experts**

Each dataset is manually curated by our team of doctors, pharmacists, public health & medical billing experts:
- Field names, descriptions, and normalized values are chosen by people who actually understand their meaning
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搜集汇总

背景与挑战

背景概述

该数据集提供美国医疗保险和医疗补助服务中心(CMS)制定的国家正确编码倡议(NCCI)中门诊医院和医师/从业者的程序间(PTP)编辑规则，包含季度更新的编码对修改信息，用于规范医疗编码实践并防止不当报销。数据经过清洗和标准化处理，便于医疗支付系统相关专业人员使用。