Part B Insider (Multispecialty) Coding Alert
ESRD Codes Hit With New Mutually Exclusive Edits
PDF
CMS introduced a number of new end-stage renal disease codes for 2004, G0308-G0327. With CCI 10.0, effective last January, a number of codes became components of these new codes. (See PBI, Vol. 4, No. 35).
New mutually exclusive edits in CCI 10.1 ensure that you won't bill for other services with HCPCS G0317 , G0318, G0319 and G0323, codes for adult ESRD services over a full month. These codes include four physician visits per month, two to three per month, one per month and none per month, respectively. The edits ensure you won't bill for ESRD services for someone over 20 and simultaneously claim the patient is also older, and that you won't claim these comprehensive codes alongside other comprehensive codes.
And new component edits make full-month codes G0308-G0323 into components of G0324-G0327, codes for services that don't last a full month.
Part B Insider (Multispecialty) Coding Alert
- Correct Coding Initiative:
8,000 Edits Hit 16 Testing Codes Hard
You can use a modifier to override these edits, but you probably shouldn't
[...] - Cystourethroscopy:
CCI 10.1 Makes 52281 Component Of Many Cystourethroscopy Codes
Harder to bill for dilation of urethral stricture or stenosis separately
CPT code 52281 (Cystourethroscopy, [...] - CCI Deletions:
Screening Culture And Blood Culture No Longer Anathema
CCI 10.1 deletes 3 mutually exclusive edits, 5 component edits
It just got easier to bill [...] - Fight Against Edits Continues
With the vast majority of CCI Edits this time around targeting a mere 16 testing [...] - ESRD:
ESRD Codes Hit With New Mutually Exclusive Edits
CMS introduced a number of new end-stage renal disease codes for 2004, G0308-G0327. With CCI [...] - Orthotics/Prosthetics:
New Code Hit With Mutually Exclusive, Bundling Edits
Billing for CPT 97755 just became much more complicated
It's been a source of [...] - Reinstated Semen Code Target of Many Edits
The Centers for Medicare & Medicaid Services reinstated semen analysis G0027 as [...] - Gastroenterology:
Intubation And Sample Collection Bundled With Slew Of Endoscopy Codes
Don't try to bill separately for esophageal dilation
If your physician routinely [...] - Part B Coding Coach:
Recoup $105 Extra Per Visit For Extended E/M Services
Your physician's time isn't free -- use prolonged service codes to bill for extra services.
Big [...] - Physician Notes:
Consultation Payments May Come With Snares Attached
If you're not 100 percent sure the consultation services you're billing meet all the correct [...]