Advanced Search

Neurology & Pain Management Coding Alert

READER QUESTIONS :

Careful With CCI Edits for TTS

Published on Thu May 28, 2009

Question: My physician sees a Medicare patient and decides the patient needs an EMG to diagnose tarsal tunnel block (TTS). We do the EMG, and then our neurologist decides to do an injection of the tarsal tunnel to relieve the patients pain. Which modifier should I use to be paid for both procedures on the same day? Utah Subscriber Answer: The Correct Coding Initiative (CCI) edits bundle many EMG codes into most 644xx codes (64400, 64402, 64408, 64410, 64412, 64413, 64415, 64416, 64417, 64418, 64420, 64421, 64425, 64430, 64435, 64445, 64446, 64447, 64448, 64449, 64450). You cannot use a modifier to bypass the edit. Medicare allows payment for the injection but not the electrodiagnostic studies. Watch LCD: Several Medicare contractors have published in local coverage determinations (LCDs) that 28899 (Unlisted procedure, foot or toes) should be reported for the injection of the tarsal tunnel rather than one of the specific [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Neurology & Pain Management Coding Alert

View All