KMAP BULLETIN: UPDATED NCCI/MUE Editing – April 2025
Date: 04/17/25
KMAP GENERAL BULLETIN 25017 (PDF)
Effective with processing date April 1, 2025, additions, revisions, and deletions related to second quarter 2025 National Correct Coding Initiative (NCCI) and Medically Unlikely Edits (MUEs) will be made according to the Medicaid quarterly files. Reference the NCCI page on the Medicaid website for additional information.
On April 10, 2025, the Center for Medicare and Medicaid Services (CMS) issued replacement files for NCCI Medicare Medically Unlikely Edits (MUE) for Healthcare Common Procedure Coding System (HCPCS) code J1628 to change the MUE value from 100 to 200, effective April 1, 2025. Reference the NCCI page on the Medicaid website for additional information.
Note: The effective date of the policy is April 1, 2025. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.