Medicare Compliance & Reimbursement

Plus: The new version of CCI also swaps several code pairs. CCI Version 14.3 blasts any ambiguity that may have existed regarding moderate sedation codes. As of Oct. 1, you'll find moderate sedation codes 99148-99149 bundled into hundreds of other surgical and procedure codes from various specialties, but a modifier can separate these bundles. Other new edits: You'll also find deep implant removal code 20680 now bundled into 15 other orthopedic surgery codes, including radius/ulna fracture repair codes 25400-25420 and tibia/fibula repair codes 27720-27726. You can use a modifier to separate these edits. Plus, scrotal exploration code 55110 now bundles into nearly 30 other codes, including orchiectomy codes 54522-54535, and testicular repair codes 54600-54692. No modifier can separate these edits. CCI also takes aim at facial nerve injection code 64402, which now bundles into over 150 eye surgery codes, including 67005-67112. A modifier will separate these edits when medically necessary. Look Out For Swapped Pairs In addition to adding new edit pairs, CCI also "swaps" several, which means that the previous column 1 code has moved to column 2, and vice versa. For example: Patellar arthroplasty codes 27437 and 27438 now bundle into knee arthroplasty code 27446, whereas previously the bundle was the other way around. "Thank goodness for this," says Jay Neal, a consultant in Atlanta. "It should have been the other way around from the get-go." Ophthalmology: Similarly, vitrectomy code 67043 now bundles into retinal detachment repair code 67113, whereas the bundling used to be reversed. Imaging: Fluoroscopic guidance code 76000 now bundles into guidance code 77002, although CCI used to publish the bundle in the reverse. CCI Offers A Few Deletions Fortunately, this round of CCI wasn't all bad news. You'll find the following bundles deleted as of Oct. 1: • 67040 (Vitrectomy with endolaser panretinal photocoagulation) with 67039 (...with focal endolaser photocoagulation). • Trigeminal nerve injection code 64400 with 66982 (Cataract removal), 66984 (Cataract removal), and 67113 (Retinal detachment repair). • Greater occipital nerve injection code 64405 with 67113 (Retinal detachment repair).