cci edit

  1. S

    90834-90837 billed with 90853 group

    Has anyone had success billing Individual psychotherapy and group therapy together on same dos? They are CCI edits, but a modifier is allowed. The group I just started working for is scheduling these on different days due to the edit, but I want to tell them that they will pay if they use a...
  2. M

    Blue Shield CCI Edit Issues

    I am having issues with Blue Shield. If a patient has an office visit and is then sent for labs (in house full service laboratory) on the same day Blue Shield denies the Office Visit as global when a urine dip (81003) is billed by the lab (we operate under one tax ID number) even if we append a...
  3. S

    Dilations and Biopsies during EGD

    My physicians will very seldom require to use an alternate method of dilation when one doesn't produce the result they desire. For example, they will perform a 43248(guide wire) and a 43249(balloon) in the same session. Most recently, we billed those two codes along with a 43239(biopsy) and...
  4. A

    26356 Tendon repair and casting

    Hi, My doc did a tendon repair 26356 and applied splinting 29125 the same day. I know that there is a note that splinting, unless replacement, is not allowed same day as restorative treatment, however when checking CCI 26356 and 29125 (splinting) can be billed together. Does the rule on...
  5. K

    Medicare CCI Edits

    HI! I am having trouble getting pass the Medicare CCI edits for CPT 20611. My doctor did a corticosteroid injection to help treat Piriformis Syndrome. The CCI edit that I am running into is as follows: [Medicare] Per Medicare's Local Coverage Determination (LCD) policies, procedure code 20611...