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CMS retroactively rescinds NCCI edits for presumptive and definitive drug testing

Pursuant to this change, MACs are required to adjust any claims denied due to the NCCI edits. This affects claims with dates of service between July 1 and October 1, 2023. Labs can also appeal the denials in lieu of waiting for the MAC adjustments.

These NCCI edits caused significant concern in the lab industry prompting NILA (the National Independent Laboratory Association) to submit a letter to CMS in August requesting that these edits be rescinded. The letter is available here: NCCILetter.pdf (

Labs, please take note of your options under this rescission of the NCCI edits and make sure you are following up to obtain reimbursement for any such denied claims.

Effective July 1, 2023, CMS implemented NCCI PTP edits between Column One codes 80305, 80306, and 80307 for presumptive test(s), and Column Two codes G0480 – G0483, and G0659 for definitive test(s). CMS will withdraw these edits retroactive to July 1, 2023 in a replacement file for the 4th quarter of 2023.


cms, reimbursement, labs, drug testing