Wiki Laparoscopy Billing

[BRETT]

Does anyone know if you can bill for both 58660 and 58673? I do not understand CCI edits. can someone please explain these and where I would find a list?

 

[jdibble]

CCI edits are used to determine if two or more codes can be billed together or if they are considered components of the main procedure performed. According to CCI edits, 58660 is included in code 58673. Usually any lysis of adhesions cannot be billed separately - it is considered part of the main surgery performed. However, according to the CCI edits, a modifier (such as 59) could be used on 58660 if the lysis was performed in a different area or at different encounter. You need to read the OP note to detemine if this is the case inorder to bill 58660-59.

You can find a list of the CCI edits at: http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html
Just click on the links at the bottom of the page for the codes you need and an Excel spreadsheet will open up. Look for the code for your main procedure in the column 1 and then look for the other code(s) in the column 2. Then see which number it is assigned - 0 means it can never be billed together, 1 means it can only with a modifier.

There are also programs that you can purchase that have electronic CCI edit tools, such as Supercoder or MedAssets (much easier) but the CMS list is free.

Hope that helps.