Advanced Search

General Surgery Coding Alert

NCCI Update:

Reporting Guidance Procedures Just Got Tougher

Published on Thu Oct 28, 2004

Edits close the door on 76003 and 76942 with dozens of codes

The latest National Correct Coding Initiative (NCCI) add dozens of bundling edits for fluoroscopic guidance and ultrasound guidance for needle placement (76003 and 76942). Already, you can't bill 76003 with vascular injections, and 76942 is bundled with vascular access codes.

Beginning Oct. 1, 76003 and 76942 are components of cardiovascular surgery codes 37207, 37209, 37250, 37620; biliary tract surgery codes 47490-47500, 47510-47530, and 47630; abdomen, peritoneum and omentum surgery codes 49021, 49041, 49061, 49080-49081, 49400 and 49423; and several other procedure types not relevant to general surgery practice.

The edits for guidance codes 76003 and 76942 also include 42550 (Injection procedure for sialography), 44901 (Incision and drainage of appendiceal abscess; percutaneous), 47011 (Hepatotomy; for percutaneous drainage of abscess or cyst, one or two stages) and 48511 (External drainage, pseudocyst of pancreas; percutaneous). Code 76003 also becomes a component of 38505 (Biopsy or excision of lymph node[s]; by needle, superficial).

But you can still report radiologic services during cardiovascular procedures:

  • for 37207 and 37209, report 75900

  • for 37250, report 75945

  • for 37620, report 75940

  • for 38505, report 76360 (for computed tomography scan), 76393 (for magnetic resonance imagery) or 76942 (for ultrasound), as appropriate.

    Look Out for Angiography Bundles

    You'll also have to be more vigilant when attempting to report separate angiography. Specifically, angiography codes 75650-75716 and 75756 become components of several transcatheter procedures.

    Angiography codes will be bundled with transcatheter procedure codes 75960-75962, 75970 and 75992. Also, 75722-75743 are components of transcatheter codes 75960-75961, 75966, 75970 and 75995, and some of those codes became components of 75994 as well.

    And vein and lymphatic radiology codes 75810-75891 all become components of transcatheter procedures codes 75961 and 75970-75978.

    No More Same-Day Consult and Hospital Admit

    NCCI 10.3 now makes initial and follow-up inpatient consultations (99251-99263) components of observation or inpatient hospital care codes 99234-99236.

    Translation: You can no longer bill for a consult if the physician also placed the patient under observation or admitted him as an inpatient, and there are no circumstances in which you may override the edits using a modifier.

    NCCI version 10.3 covers the final quarter of 2004, beginning Oct. 1 and ending Dec. 31.

    • Other Articles in this issue of

    General Surgery Coding Alert

    View All