Wiki Edit for 36556 & 76942-26

[lcole7465]

I'm stumped. We just started getting an edit when coding 36556 along with U/S Guidance code 76942-26 for an epidural placement. It's stating that an additional modifier needs to be used. I have not seen this edit before, as this is U/S is for the epidural not the CVP line, we use a different U/S code for the lines.

Any input would be appreciated or is this something I may have to contact the Correct Coding Initiative in regards to this one.

Thank you

 

[dwaldman]

36556 76942 20040101 * 1

CPT Manual or CMS manual coding instructions

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Above is from the PTP coding edits from the NCCI page. It states the edit is based on "CPT manual or CMS manual coding instructions" but it is hard to know which instructions they are referencing. I would write them and ask if it a separate site is ok to report modifier 59 when U/S guidance is separately used from U/S guidance for central line and when a separate block is performed.

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Code 76937(column 1) has a CCI conflict with code 76942(column 2). A modifier is allowed to override this relationship.

Code 36556(column 1) has a CCI conflict with code 76942(column 2). A modifier is allowed to override this relationship.


http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html


the viewer has concerns about specific NCCI edits, he/she may submit comments in writing to:

National Correct Coding Initiative
Correct Coding Solutions LLC
P.O. Box 907
Carmel, IN 46082-0907

Attention: Niles R. Rosen, M.D., Medical Director and Linda S. Dietz, RHIA, CCS, CCS-P, Coding Specialist

Fax #: 317-571-1745