71045 and 74018

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Has anyone noticed with the new for 2018 chest and abdomen x-ray single view codes that they hit a bundling edit? There is a CCI edit based on "HCPCS/CPT procedure code definition". It does say a modifier can be used, but we're still thinking the edit is in error as these are 2 distinct body regions and the old codes never bundled. Does anyone know or understand the rationale behind this?
71045 Radiologic examination, chest; single view
74018 Radiologic examination, abdomen; 1 view
 

lanaa

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Lana R Adams, CPC Supervisor

The ACR contact CCS regarding this edit of 71045 column 1 code and 74018 column 2 code which was implemented on January 1, 2018. CCS investigate the code pair and determined that the edit was firing incorrectly on the NCCI. They are working to obtain approval from CMS/NCCI to delete the edit April 1, 2018's quarterly update. This correction will be retroactive back to January 1, 2018. Until then, three options were recommended: 1: Hold claims for this edit until April 1. 2) Release and file appeals for 74018 after the update April 1, 2018. 3: Append the 59 modifier on the different anatomic site with dates January 1 thru March 31st when the edit correction will take place and this edit will be deleted, April 1. This was on a FaceBook website for Radiology and I just tried to relay the most relevant information. I have asked that my coders append the 59 modifier given the three choices.
 

ciphermed

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The April 2018 NCCI tables have been published on the CMS website; the edit has been deleted effective Jan. 1, 2018. Thanks to the ACR.
 
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