Part B Insider (Multispecialty) Coding Alert

Published on Wed Aug 24, 2005 PDF

Evaluation and management codes 99239, 99298-99350, 99431-99440 and 99455-99456 will become components of clinical brachytherapy codes 77750-77763 and 77777-77790 in Correct Coding Initiative version 11.3. You won't be able to use a modifier to override these edits.

• 76375 (Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computed tomography, magnetic resonance imaging, or other tomographic modality) will become a component of 136 different codes. These include almost every code from the diagnostic nuclear medicine section of the CPT book, except for a few add-on codes and unlisted codes.

• 36000 (Introduction of needle or intracatheter, vein) and 36410 (Venipuncture, age 3 years or older, necessitating physician's skill, for diagnostic or therapeutic purposes) both become components of echocardiography codes 93303-93318.

• Endoscopy codes 43202-43232 will all become components of 43235 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing), and you won't be able to use a modifier to override these edits.

• Add-on code +49568 (Implantation of mesh or other prosthesis for incisional or ventral hernia repair) will become a component of abdominal surgery codes 49570-49651. You can't use a modifier to override these edits.

• CCI 11.3 makes esophageal manometry codes 91011 (...with mecholyl or similar stimulant) and 91012 (...with perfusion studies) mutually exclusive. This is the only new mutually exclusive edit this fall.