Anesthesia Coding Alert

Watch edits for injection, neuroplasty and neurostim codes The latest National Correct Coding Initiative (NCCI) edits, effective April 1, once again target injection codes. NCCI Edits version 10.1 bundles 17 neurological testing codes into the nerve injection codes (somatic nerve injections [64400-64484], sympathetic nerve injections [64505-64530], and somatic and sympathetic nerve destruction [64600-64681]). NCCI also bundles these 17 codes into neuroplasty procedures 64702-64727 and the neurostimulator placement and implantation codes 64550-64595.
 
The 17 codes that are bundled into these procedures are:

CPT 92585 -- Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive
CPT 95822 -- Electroencephalogram (EEG); recording in coma or sleep only
Needle electromyography codes 95860, 95861, 95867 and 95868
Nerve conduction, amplitude and latency/velocity study codes 95900 and 95904
+CPT 95920 -- Intraoperative neurophysiology testing, per hour (list separately in addition to code for primary procedure)
Codes CPT 95925 , 95926 and 95927 related to Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system
Evoked potentials and reflex tests 95930 (Visual evoked potential [VEP] testing central nervous system, checkerboard or flash) and 95933 (Orbicularis oculi [blink] reflex, by electrodiagnostic testing)
H-reflex tests 95934 (H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle) and 95936 (... record muscle other than gastrocnemius/soleus muscle)
CPT 95937 -- Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any one method. NCCI Bundles Pump Code Maintenance NCCI 10.1 also bundles 96530 (Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic [e.g., intravenous, intra-arterial]) into the pump analysis codes 62367 (Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion [includes evaluation of reservoir status, alarm status, drug prescription status]; without reprogramming) and 62368 (... with reprogramming).

"You almost have to refill the pump when you're adjusting it, but Medicare apparently doesn't want us to charge separately for it," says Barbara Johnson, CPC, MCP, a California coding consultant. "The edits state 'misuse of column 2 code with column 1 code' as the reason for this pairing."