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Pulmonology Coding Alert

CCI Edits:

CCI 16.3 Highlights Pulmonary Rehab with Mutually and NME Edits

Published on Wed Sep 22, 2010

Uncover which of the 150 NMEs won't unbundle with any modifier.If you commonly report pulmonary rehab code G0424, then you need to pay attention to the Correct Coding Initiative (CCI) edits version 16.3, which took effect October 1. Three of the 33 new mutually exclusive pairs concern pulmonologists, while non-mutually exclusive edits include 150 bundles representing pulmonary rehab.In general, CCI 16.3 features 19,667 additions (33 mutually exclusive edits; 19,634 NMEs), and 31 deletions.Highlight These Mutually Exclusive Pulmonary Rehab PairsOnly 3 mutually exclusive edits should affect pulmonologists in this latest version. Mutually exclusive edits mean the code pair "represents procedures or services that could not reasonably be performed at the same session by the same provider on the same beneficiary," according to CMS. Medicare will only reimburse you for the lesser-valued of the two procedures.The new comprehensive pulmonary rehab (PR) code G0424 (Pulmonary rehabilitation, including exercise and monitoring, per hour, per [...]
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