Ophthalmology and Optometry Coding Alert

CCI 15.3 Update:

Include Moderate Sedation in Nearly All Eye Codes

Key: Role of second physician is critical in determining claims. Ophthalmology coders can sum up this round of CCI bundles in seven words: Check the edits before reporting moderate sedation. If you thought CCI left no stone unturned in bundling moderate sedation, think again. Correct Coding Initiative (CCI) version 15.3, effective Oct. 1, continues the trend, bundling 99148-+99150 into most other CPT codes. Medicare allows no modifier to separate the bundles. Roughly 80 percent of the new bundles relate to moderate sedation codes 99148-+99150 (Moderate sedation services [other than those services described by codes 00100-01999], provided by a physician other than the health care professional performing the diagnostic or therapeutic service that the sedation supports ...), according to the Sept. 11 "NCCI 15.3 Update" news release by Frank Cohen, MPA, senior analyst with MIT Solutions Inc. in Clearwater, Fla. These edits carry a modifier indicator of "0," which means you [...]
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

Ophthalmology and Optometry Coding Alert

View All