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Oncology & Hematology Coding Alert

Reader Question:

79005 and More Saw CCI 17.1 Changes

Published on Wed Sep 07, 2011

Question: I've been hearing that a lot of the April CCI nuclear medicine updates changed modifier indicators retroactive to January. Does that mean we can resubmit the claims for payment?Maryland SubscriberAnswer: When Correct Coding Initiative (CCI) edits are modified or deleted retroactive to a specific date, you may resubmit claims denied because of the edit when the date of service is on or after that specific date.Regarding version 17.1's retroactive changes to modifier indicators for nuclear medicine edits, the column 1 codes involved all describe radiopharmaceutical therapy. The column 2 codes describe radiopharmaceutical imaging, uptake, and tumor localization, along with patency test code 78291 (Peritoneal-venous shunt patency test [e.g., for LeVeen, Denver shunt]).The change is retroactive to Jan. 1, 2011, so you may resubmit claims denied because of the edits for dates of service between Jan. 1 and March 31.
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