NCCI Claims Validation — CPT Code Pair Edits + MUE Limits

Name: NCCI Claims Validation — CPT Code Pair Edits + MUE Limits
Author: easysolutions906

@easysolutions906

关于 NCCI Claims Validation — CPT Code Pair Edits + MUE Limits

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

基本信息

分类

开发工具

传输方式

stdio

发布者

easysolutions906

提交者

easysolutions906

配置

使用下面的配置,将此服务器添加到你的 MCP 客户端。

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

工具

未检测到工具

工具是从 README 中自动提取的。维护者可以在 ## Tools 标题下列出工具,即可填充这部分内容。

概览

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

FAQ from NCCI Claims Validation — CPT Code Pair Edits + MUE Limits

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.

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.

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.

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.

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).