Advanced Search

Oncology & Hematology Coding Alert

CCI 16.3:

88738 Bundle With 85025 and 85027 Has a New Modifier Indicator … Again

Published on Tue Oct 12, 2010

Noting the retroactive date could pay off.If your center has a lab, it might get a request for two medically necessary hemoglobin tests by different methods in a single day, and as of last quarter, you couldn't bill for both, according to the Correct Coding Initiative (CCI) edits for physicians. but the October release brought different news.Modifier Indicator Matters for ReimbursementEffective Jan. 1, 2010, CCI bundled 88738 (Hemoglobin [Hgb], quantitative, transcutaneous) with 85025 (Blood count; complete [CBC], automated [Hgb, Hct, RBC, WBC, and platelet count] and automated differential WBC count) and 85027 (... complete [CBC], automated [Hgb, Hct, RBC, WBC, and platelet count]).Whether you can unbundle these edit pairs for distinct specimens by using a modifier has been a changing proposition each quarter this year. Here's the CCI modifier indicator for these edit pairs over the course of 2010: CCI 16.0 -- modifier indicator "0" effective Jan. 1, 2010CCI 16.1 -- modifier [...]
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

Oncology & Hematology Coding Alert

View All