Part B Insider (Multispecialty) Coding Alert

Published on Fri Aug 20, 2010 PDF

Plus: Work ICD-10 costs into your budget

Effective Oct. 1, a new edition of the Correct Coding Initiative (CCI) will take hold of your coding. Version 16.3 includes over 19,000 new edit pairs and over 220,000 terminated pairs.Most of the new additions revolve around the newly-introduced Category III CPT codes that went into effect on July 1, as follows:

• 0228T -- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance,  cervical or thoracic; single level
• 0230T -- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; single level

CCI 16.3 bundles these codes into hundreds of other codes spanning throughout every section of CPT, from anesthesia to the physical therapy codes. 0228T and 0230T apply when the physician uses ultrasound guidance when administering transforaminal epidural injections. In most cases, no modifier can separate the edits bundling 0228T and 0230T into other codes.

Plus: You'll now find psychological testing codes 96101-96105 and neuropsychological testing codes 96118-96125 bundled into almost all of the E/M codes (99201-99480). You can use a modifier to separate these edits when the services are performed as separately identifiable services.

Modifier indicator: The new edition of CCI offers some good news by allowing you to now use a modifier to separate the edits bundling 64530 (Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring) into endoscopy codes 43232, 43238, and 43242. In the past, you could not use any modifiers to separate these services if you performed them during the same session, but effective Oct. 1, you'll be able to use a modifier (such as 59, Distinct procedural service) to separate these edits when your physician performs separately identifiable services during the same session.

To read a full overview of CCI edits, visit the CMS Web site at www.cms.gov/nationalcorrectcodinited.