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MLN Provider Compliance

The Medicare Learning Network

Fast Fact

For Procedure-to-Procedure (PTP) edits that have a Correct Coding Modifier Indicator (CCMI) of “0,” the codes should never be reported together by the same provider for the same beneficiary on the same date of service. If they are reported on the same date of service, the column one code is eligible for payment and the column two code is denied.  Refer to MLN Matters® Special Edition Article #SE1418 for more information.

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The Medicare Learning Network® (MLN) Provider Compliance page contains educational products that inform health care professionals on how to avoid common billing errors and other improper activities when dealing with various CMS Programs. CMS’ claim review program’s overall goal is to reduce improper payment error by identifying and addressing coverage and coding billing errors. Since 1996, CMS has implemented several initiatives: to prevent improper payments before a claim is processed; and to identify, and recoup improper payments after the claim is processed.

The Downloads section contains MLN products, MLN Matters® Articles, and the “Archive of Medicare Quarterly Provider Compliance Newsletters” which have been designed to provide education on common billing errors and other improper activities. These lists, as well as other information in the Downloads and Related Links section, are updated as new products and articles are developed and existing products and articles are revised.

If you would like to contact the MLN, please email us at MLN@cms.hhs.gov.