What was developed to reduce Medicare program expenditures?

The National Correct Coding Initiative (NCCI) was developed to reduce unnecessary expenditures in the Medicare program by promoting correct coding methodologies. It achieves this by identifying and preventing improper billing for Medicare services, thereby reducing the risk of fraud and abuse. The NCCI uses a set of coding policies that define which services and procedures should or should not be billed together.

By establishing these bundling edits, NCCI encourages providers to submit claims that reflect medically necessary services delivered during a patient’s encounter. The initiative ultimately aims to ensure that Medicare beneficiaries receive appropriate care while also safeguarding program funds from unnecessary claims. This plays a critical role in maintaining the sustainability of the Medicare program by minimizing improper payments.

Other options, while they play significant roles in healthcare practice, do not directly focus on reducing expenditures in the same manner as NCCI does. For instance, the CMS-1500 form is used for billing, the Medicare Call Center assists beneficiaries with questions rather than managing costs, and the Medicare Improvement Act encompasses various measures but does not specifically target expenditure reduction through code integrity like NCCI does.