About DenialStop

Our Mission

DenialStop exists because pre-submission coding checks shouldn't require a subscription, a login, or an enterprise contract. Medical billing teams — from solo practices to multi-specialty groups — need fast access to the same NCCI, MUE, and modifier reference data that payers use to adjudicate claims.

Every tool on DenialStop runs entirely in your browser against CMS-published data. No patient information is sent to a server. No claims data is stored. The tools are free, with no account required.

The Tools

• NCCI Bundling Checker — Check CPT and HCPCS code pairs against CMS NCCI PTP edits. Identifies hard bundles (modifier indicator 0) and soft bundles (modifier indicator 1) with plain-English guidance.
• Denial Risk Calculator — Heuristic pre-billing risk scoring for CPT + ICD-10 pairs. Reviews bundling, modifier gaps, diagnosis-procedure alignment, and MUE limits in one pass.
• MUE Lookup — Look up the CMS Medically Unlikely Edit unit limit and MAI adjudication indicator for any CPT or HCPCS code.
• Full Claim Scrubber — Validate an entire claim before submission: NCCI pairs, MUE unit limits, modifier requirements, and diagnosis mismatches.
• Modifier Advisor — Look up any CPT modifier: definition, when to use it, documentation requirements, and payer notes.
• Medicare Fee Schedule — Look up RVU values and national payment rates for any CPT or HCPCS code, with facility and non-facility breakdowns.

Data Sources

• NCCI PTP Edits: CMS National Correct Coding Initiative, 2026 Q2
• MUE Limits: CMS Medically Unlikely Edits, Q2 2026
• Medicare Fee Schedule: CMS Physician Fee Schedule, 2026 Q3 (PPRRVU)

All data is sourced directly from CMS and updated quarterly. Actual payer adjudication may differ from CMS published values.

Medical Billing Disclaimer

DenialStop is a reference tool, not a payer adjudication engine. Results reflect CMS published data and general billing rules. They are not a guarantee of coverage or payment. Billing decisions should be made by qualified coders or billing professionals familiar with applicable payer policies, LCD/NCD guidance, and documentation requirements. DenialStop assumes no liability for billing or coding decisions made using these tools.

Contact

Questions or feedback? Email us at support@denialstop.com.