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Pathology/Lab Coding Alert

CCI 16.2:

Avoid HCPCS Level II Edit Pairs or Miss Drug Screen Pay

Published on Sat Jun 12, 2010

Distinguish telehealth from lab consults, too.Effective July 1, you have plenty of new edit pairs to stay on top of for your lab, thanks to Correct Coding Initiative (CCI) version 16.2.Mind-boggling numbers: CCI 16.2 includes "16,843 new edit pairs, bringing the total number of active edit pairs to 653,718," said analyst Frank Cohen, MPA, MBB of The Frank Cohen Group, LLC, in a recent announcement about the CCI changes.In addition to edit pairs you read about in "Shun Extra Tissue Prep Charge for Micro and Flow" on page 49, your lab will need to focus on a number of "G" code bundles that could impact your pay. Concede to Drug Screen and 'Method' BundlesCMS instructs labs to use the following new-for-2010 HCPCS Level II codes for certain drug screen testing for Medicare beneficiaries:G0430 -- Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedureG0431 -- ... single drug class method [...]
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