Which key system is used to prevent improper billing in healthcare coding?

The National Correct Coding Initiative (NCCI) is a key system designed to prevent improper billing in healthcare coding. This initiative, developed by the Centers for Medicare & Medicaid Services (CMS), aims to promote correct coding methodologies and reduce the chance of improper payments resulting from unbundling or inappropriate code combinations.

NCCI provides a set of coding guidelines and edits, which are essentially rules that guide coders in properly coding procedures and services offered to patients. For example, if two codes should not be billed together under certain circumstances, these guidelines would prevent the coder from improperly submitting both codes for payment. This is crucial in maintaining compliance and minimizing fraud and abuse in healthcare billing.

Other systems mentioned have different purposes. The MS-DRG and DRG systems primarily focus on grouping inpatient hospital services for payment purposes, while HCPCS is a coding system for healthcare procedures, products, and services, but it does not specifically address billing accuracy like NCCI does. Therefore, NCCI is the most relevant system for ensuring proper billing practices in healthcare coding.