Medicare Compliance & Reimbursement

Here's expert advice on reporting your code combinations correctly. The Correct Coding Initiative (CCI) offers guidance on which codes you shouldn't bill to Medicare together, and which you can report together with modifiers. But there are exceptions to every rule, and Medicare wants to make sure your coding doesn't fit one of these potential exceptions. Medicare carriers routinely review claims to determine whether your physician reported codes together properly  -- meaning that you should only report the most accurate codes, and you shouldn't bill "extra" codes just because CCI allows it. Here are examples of common "unbundling" scenarios that Medicare carriers do not want you to report, along with rationale, courtesy of Barbara J. Cobuzzi, MBA,CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J. Bone marrow aspiration: If your physician performs bone marrow aspiration and a bone marrow biopsy during the same session, CCI will [...]