Part B Insider (Multispecialty) Coding Alert

Published on Sat Aug 23, 2008 PDF

Effective Oct. 1, CCI institutes thousands of edits that change modifier status, and delete and add bundles

Many coders are under the impression that the Correct Coding Initiative (CCI) doesn't make many changes near the end of the year, but the new CCI Version 14.3 dispels that commonly held myth.

CCI 14.3 makes over 306,000 changes to its listing of edit pairs, zooming in particularly on anesthesia edits, with over 66,000 changes aimed at codes in the 00000-09999 range. Plus, CCI adds 3,272 new edits that will restrict which codes you can report together as of Oct. 1.

According to version 14.3, you can no longer use a modifier to separate the edit bundling 92502 (Oto-laryngologic examination under general anesthesia) into most of the codes from the 30000-31595 range and the 40490-43774 range. How-ever, most practices probably would not report these together, says Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Health-care Solutions, and senior coder and auditor for The Coding Network.

"When the physician is performing a sinus surgery, he wouldn't need to perform an examination, unless he was looking at another site, such as the throat," Cobuzzi says.

In addition, you can no longer use a modifier to separate the edits bundling the following code pairs:

• Scrotal exploration code 55110, which bundles into codes 54520 (Orchiectomy) and 55100 (Scrotal wall abscess drainage).

• Flu shot codes 90645-90648, which bundle into DPT shot code 90721.

• DPT codes 90700-90703, which bundle into DPT code 90721.

It's not all bad news: You previously could not use a modifier to separate the edit pairs listed below, but now you can:

• Cystourethroscopy code 52352 into "with lithotripsy" code 52353.

• Facial nerve injection code 64402 with cataract removal code 66982.