Modified barium swallow- 2020 edit issue

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Hi everyone,
As of 1/1/2020 I am getting a weird edit for charging CPT 74230 and 92611 together for modified barium swallow. These have always been charged together, 74230 for the radiology portion and 92611 for the Speech language pathologist portion. Suddenly as of 2020 we are getting an edit through N-thrive indicating that 74230 cannot be billed with 92611, and a modifier is not allowed to bypass the edit.

I have gone through all of my resources and I'm at a loss. I do see that for 2020 the long code description for CPT 74230 was revised. (It basically became more detailed), but no where does it indicate that 74230 and 92611 cannot be billed together. In fact the current 2020 code description for CPT 92611 indicates that 74230 should be charged in addition for radiological supervision and interpretation.

Anyone hear anything about this, or encounter this? Any thoughts?
 

emb0210@gmail.com

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Everyone seems to be having this issue and no one has any real answers as to what can be done other than discussing this with the powers that be. Still waiting for some kind of direction on this issue. Where did you see that a modifier is not allowed to bypass the edit and what modifier were you considering using?
 
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DEBBIEOZ2

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Any update on CPT 74230 and 92611 together? I just got a denial from 2/7/2020. I am at a loss along with Shannon J Moss!
 

cyprice

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I came across an article that explained this. The link to the full article is https://www.asha.org/News/2020/New-CCI-Edit-Prevents-Same-Day-Billing-of-Videofluoroscopic/.

Effective January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) implemented a new National Correct Coding Initiative (CCI) edit that prevents same-day billing of Current Procedural Terminology (CPT ® American Medical Association) codes 74230 (Radiologic examination, swallowing function, with cineradiography/videoradiography) and 92611 (Motion fluoroscopic evaluation of swallowing function by cine or video recording).

I hope this helps.
 
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