Review compliance intelligence surfaces
Use precomputed PTP conflict density and MUE unit-constraint surfaces to prioritize what gets reviewed first in coding and denial-prevention workflows.
Source snapshot: cms.ncci.ptp.2026q1@2026-Q1 · Schema: ncci-frequency-summary.v1
O10 · NCCI Conflict Frequency Board
Precomputed conflict-density summary built from NCCI PTP artifacts to support queue prioritization.
Precompiled NCCI conflict summaries meet full support thresholds for family-level analysis.
Support: 3,344,416 of 3,344,416 entities met support thresholds.
Snapshot cms.ncci.ptp.2026q1@2026-Q1 · Schema ncci-frequency-summary.v1 · Generated 4/6/2026
Frequency context for NCCI PTP relationships by code family and high-density primary codes.
- Data must come from precompiled summary artifact
- Runtime shard fan-out is prohibited
- Precomputed aggregate summary only; does not replace code-pair-level validation.
- Not an adjudication or denial prediction model.
Composition by category
Stacked horizontal bar chart showing Modifier-allowed pairs and Other conflict pairs by category.
- 12 categories shown with stacked values for Modifier-allowed pairs and Other conflict pairs.
- 27 has the highest combined total at 172,908.
| Category | Modifier-allowed pairs | Other conflict pairs | Total |
|---|---|---|---|
| 27 | 146,535 | 26,373 | 172,908 |
| 33 | 121,591 | 30,547 | 152,138 |
| 00 | 96,429 | 24,716 | 121,145 |
| 01 | 76,131 | 19,674 | 95,805 |
| 81 | 91,567 | 1,108 | 92,675 |
| 43 | 72,125 | 19,708 | 91,833 |
| 26 | 75,011 | 12,824 | 87,835 |
| 28 | 74,404 | 12,339 | 86,743 |
| 21 | 70,023 | 14,361 | 84,384 |
| 64 | 62,141 | 15,423 | 77,564 |
| 61 | 59,998 | 17,206 | 77,204 |
| 31 | 60,446 | 12,945 | 73,391 |
O11 · MUE Constraint Surface
MUE unit caps grouped by constraint severity so teams can stage tighter pre-submit checks first.
MUE unit-constraint rows meet required support for tracked code bands.
Support: 13,800 of 13,800 entities met support thresholds.
Snapshot cms.ncci.mue.2026q1@2025-12-06T15:08:12.748Z · Schema intelligence.compliance.mue-constraint-surface.v1 · Generated 4/6/2026
NCCI MUE unit caps grouped by constraint severity to highlight pre-submit review pressure.
- Constraint rows require max units and rationale fields
- Band assignment requires deterministic threshold mapping
- MUE limits are one compliance input and do not determine clinical appropriateness.
- This surface is aggregate planning context, not claim adjudication guidance.
Constraint band share
Constraint band share. Donut chart showing category share of the total.
- 4 categories shown.
- Total value across categories: 13,800.
- Hard stop is the largest slice at 8,783 (63.6%).
| Category | Value | Share |
|---|---|---|
| Hard stop | 8,783 | 63.6% |
| Review priority | 2,968 | 21.5% |
| Moderate | 746 | 5.4% |
| Flexible | 1,303 | 9.4% |
Ranked trend profile
Line chart showing ranked max units values across 24 points.
- 24 ranked points shown.
- 13133 has the highest max units at 7.
- 0007M has the lowest max units at 1.
| Rank | Label | Max units |
|---|---|---|
| 1 | 13133 | 7 |
| 2 | 15201 | 7 |
| 3 | 17260 | 7 |
| 4 | 17261 | 7 |
| 5 | 25260 | 7 |
| 6 | 75774 | 7 |
| 7 | 0106T | 4 |
| 8 | 0107T | 4 |
| 9 | 0108T | 4 |
| 10 | 0109T | 4 |
| 11 | 0110T | 4 |
| 12 | 0164T | 4 |
| 13 | 0009U | 2 |
| 14 | 0010U | 2 |
| 15 | 0016M | 2 |
| 16 | 0018U | 2 |
| 17 | 0022U | 2 |
| 18 | 0026U | 2 |
| 19 | 0003M | 1 |
| 20 | 0003U | 1 |
| 21 | 0004M | 1 |
| 22 | 0005U | 1 |
| 23 | 0006M | 1 |
| 24 | 0007M | 1 |
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Boundary
Frequency context for NCCI PTP relationships by code family and high-density primary codes.
Supports compliance planning by showing where conflict density concentrates before case-level review.
- Precomputed aggregate summary only; does not replace code-pair-level validation.
- Not an adjudication or denial prediction model.