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Pediatric Coding Alert

CCI 17.1:

No Modifier Will Allow You to Report 99211 With Vaccine Code 90460

Published on Tue Apr 12, 2011

Plus: One edit will face 'swapped columns'You may just be getting used to the new codes in CPT 2011, but the latest edition of CCI, effective April 1, intends to make some code pairings impossible. Medicaid payers will be using these edits to deny services performed concurrently, and some private payers also follow CCI rules when they determine which services to bundle together.The Correct Coding Initiative (CCI) released version 17.1 in March, revealing 11,831 new edit pairs and 346 terminations, said Frank D. Cohen, MPA, MBB, senior analyst with MIT Solutions, Inc., in a March 17 statement.New bundles: Among the new edits that were instituted on April 1, you'll find that E/M code 99211, which is often used for a nurse's visit with a patient, is bundled into the new vaccine administration code 90460 ((Immunization administration through 18 years of age via any route of administration, with counseling by physician [...]
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