In Billing
Dec 8th, 2014
You may claim unlisted procedure codes only if an existing CPT® Category I or Category III code does not describe the procedure you wish to report. Per Chapter 1 of the National Correct Coding Initiative Policy Manual for Medicare Services, “A physician should not report a CPT® code for a specific procedure if it does ...
In CMS
Dec 1st, 2014
If the provider uses fluoroscopic guidance during an endoscopic procedure, you may never report the fluoroscopic guidance separately, for Medicare payers. Per Chapter VII of the National Correct Coding Initiative Policy Manual for Medicare Services: If fluoroscopy is performed during an endoscopic procedure, it is integral to the procedure. This principle applies to all endoscopic ...
In Audit
Oct 15th, 2014
Coders learn early and are reminded often to avoid unbundling, or separately reporting procedures/services that are meant to be reported together, using a single code. As the introduction of the National Correct Coding Initiative (NCCI) Policy Manual explains, “Procedures should be reported with the most comprehensive CPT® code that describes the services performed.” To make ...
In Coding
Sep 19th, 2014
Most experienced coders are familiar with the rule, “surgical endoscopy always includes diagnostic endoscopy.” These guidelines are outlined in Chapter I of the “General Correct Coding Policies for National Correct Coding Initiative Policy Manual for Medicare Services,” which states: Diagnostic endoscopy is never separately reportable with another endoscopic procedure of the same organ(s) when perf...
In Coding
Sep 19th, 2014
CPT® provides a single code to report endotracheal intubation—31500 Intubation, endotracheal, emergency procedure—but application of this code isn’t always straightforward. Per CPT® and National Correct Coding Initiative (NCCI) guidelines, 31500 describes an emergency endotracheal intubation and should not be reported for elective endotracheal intubation. CPT Assistant (Dec. 2009) clarifies, “Code ...