CLAIM EDIT INTELLIGENCE
Catch the conflicts. Understand the rules.
Check procedure pairs against the official Medicare practitioner NCCI PTP release.
Review procedure pairs
Practitioner claims · 2–20 distinct codes · service date 2026-11-02
What the indicators mean
0
No modifier override
The code-pair edit cannot be bypassed with an NCCI-associated modifier.
1
Potential modifier exception
An appropriate modifier may bypass the edit only when the clinical circumstances and documentation qualify.
9
Edit not applicable
Deleted or inapplicable edits are excluded from active findings for the selected date.
SCOPE MATTERS
A precise check.
An explicit boundary.
This tool checks the practitioner PTP file, regardless of the pricing place-of-service selector. Hospital outpatient PTP is a separate edit set.
Official NCCI reference