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NCCI Claims Validation — CPT Code Pair Edits + MUE Limits MCP Se…

@easysolutions906

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easysolutions906

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easysolutions906

NCCI Claims Validation — CPT Code Pair Edits + MUE Limits MCP Server について

Validate CPT/HCPCS code pairs against NCCI edits. Check if codes can be billed together, what modifiers are needed, and MUE unit limits. Prevents claim denials. No public API like this exists.

#ncci#medicalbilling#cpt#claims#compliance#healthcare#mcp

NCCI Claims Validation — CPT Code Pair Edits + MUE Limits MCP Server の設定

以下の設定を使って、このサーバーを MCP 対応クライアントに追加してください。

{
  "mcpServers": {
    "ncci": {
      "command": "npx",
      "args": [
        "-y",
        "@easysolutions906/ncci-api"
      ]
    }
  }
}

NCCI Claims Validation — CPT Code Pair Edits + MUE Limits MCP Server のツール

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概要

What is NCCI Claims Validation — CPT Code Pair Edits + MUE Limits?

A Model Context Protocol (MCP) server that validates CPT/HCPCS code pairs against CMS National Correct Coding Initiative (NCCI) edits. It checks Procedure-to-Procedure (PTP) bundling edits and Medically Unlikely Edits (MUE) to help prevent claim denials for medical billers and compliance teams.

How to use NCCI Claims Validation — CPT Code Pair Edits + MUE Limits?

Install and run via npx @easysolutions906/ncci-api. Configure as an MCP server in Claude Desktop (claude_desktop_config.json) or Cursor (.cursor/mcp.json). Optionally run as an HTTP server by setting the PORT environment variable. Use the provided tools (ncci_validate_pair, ncci_validate_claim, ncci_edits, ncci_mue, ncci_search) to perform validations.

Key features of NCCI Claims Validation — CPT Code Pair Edits + MUE Limits

  • Five MCP tools for pair, claim, code edits, MUE, and search
  • Covers 20+ medical specialties (allergy to wound repair)
  • Returns modifier requirements, edit status, and rationale
  • Free tier (20 validations/day) with paid plans up to 50,000/day
  • Supports stdio (local) and HTTP (Streamable HTTP) transports
  • Audit trail with data version, build date, and timestamp

Use cases of NCCI Claims Validation — CPT Code Pair Edits + MUE Limits

  • Checking if two CPT codes can be billed together before claim submission
  • Validating an entire claim for all PTP edits and MUE violations
  • Looking up all NCCI edits for a specific code and its bundled pairs
  • Determining the maximum units allowed per code (MUE limits)
  • Searching edits by code, procedure name, or category

よくある質問

1

How does this differ from using raw CMS NCCI files?

It provides instant, programmatic validation with clear modifier guidance instead of requiring manual parsing of quarterly CMS data.

2

What are the dependencies and runtime requirements?

Requires Node.js and npx. The server runs locally via stdio or can be deployed as an HTTP server.

3

Where does the NCCI data live, and is it updated?

Data is bundled with the server and covers multiple specialties. It can be updated by running `npm run build-data`. Each response includes the CMS quarter (`dataVersion`) and build date.

4

What transports and authentication are available?

Default transport is stdio; set `PORT` env var for Streamable HTTP mode on `/mcp`. HTTP servers optionally require an `ADMIN_SECRET` for the checkout and admin endpoints. The MCP tools themselves do not require authentication.

5

Are there any usage limits?

Yes. The free plan allows 20 validations per day with 5 per minute rate. Paid plans remove those limits (Starter: 500/day, Pro: 5,000/day, Business: 50,000/day).

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