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Otolaryngology Coding Alert

Coupon Leaves No Excuses for Edit Ignorance

Published on Thu May 01, 2003

Otolaryngologists and coders who complain of difficulty keeping up with the constant coding edits have a useful tool at their grasp. Simply post this easy chart close at hand, and your practice can catch a glimpse of the most recent otolaryngology edits. The National Correct Coding Initiative (NCCI) version 9.1, effective April 1-June 31, adds several edits that affect new CPT 2003 codes. The bundles are from the nonmutually exclusive section, which lists a comprehensive code that includes the component code. Because the physician cannot perform the primary procedure without the secondary part, CMS does not permit billing both codes together. CMS assigns reasons for these edits and a modifier. When the bundle contains a "1," Medicare allows a modifier to override the edit under certain circumstances. On the other hand, a "0" modifier does not permit unbundling in any cases. See article 10 for edits.
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