How it Works

The Medex NCCI Checker performs a real-time, multi-layer analysis of your CPT and ICD-10 codes against the latest 2026 CMS databases.

• NCCI PTP Edits: Detects unbundling errors between procedure pairs. Checks over 675,000 edits.
• MUE Limits: Verifies if the units billed exceed the Medically Unlikely Edit limits for that date of service.
• LCD Coverage: Cross-references Local Coverage Determinations based on your specific Jurisdiction (MAC) to ensure the diagnosis supports the procedure.

Why Check Medical Necessity?

Claim denials due to "Medical Necessity" or "Bundling" account for nearly 40% of all lost revenue in outpatient settings.

By checking codes before submission, you can identify:

• When a Modifier -25 or -59 is actually allowed and justified.
• Which specific ICD-10 codes are approved for a procedure in your state.
• When you are billing too many units of a drug or service.