Advanced Search

Neurosurgery Coding Alert

CCI 16.1 Targets Arthrodesis, Arthroplasty With Both Mutually and NME Neurosurgery Edits

Published on Sun Mar 21, 2010

Pay attention to the edits that carry modifier indicator "0." The Correct Coding Initiative (CCI) Version 16.1 went into effect April 1, with almost 40 percent of 112 new mutually exclusive pairs applying to neurosurgeons. Non-mutually exclusive edits include 67 pairs listing head, spine, or nervous system procedures as the comprehensive component. As a whole, CCI 16.1 includes 2,054 new edit pairs, with 1,947 modifier indicator changes, says Frank Cohen, MBB, MPA, of MIT Solutions Inc. in Clearwater, Fla. Watch Exclusive Arthrodesis, Arthroplasty Pairs Mutually exclusive edits affecting neurosurgeons are split almost equally between arthrodesis and total disc arthroplasty procedures. Remember: Mutually exclusive edits mean the code pair "represents procedures or services that could not reasonably be performed at the same session by the same provider on the same beneficiary," according to CMS. Medicare will only reimburse you for the lesser-valued of the two procedures. Codes for posterior and anterior [...]
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

Neurosurgery Coding Alert

View All