Question on Podiarty procedure


Levittown, NY
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Touching on a new specialty: Podiatry

I have a doctor who would like to bill CPT Codes 28292,13132 & 64450 CCI Edits state that 13132 & 64450 are column 2 codes
I have explained to the doctor that these codes can NOT be billed for they are part of the main procedure code 28292

Is there some documentation I can give the doctor that explains this?

Thank you in advance,



True Blue
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You can find most of the rationale for the NCCI edits in the NCCI policy manual on the CMS web site. For this particular code combination, I'd refer the provider to chapter 1, general correct coding policies, pages I-9 and I-10: "Examples of services integral to a large number of procedures include...Local, topical or regional anesthesia administered by the physician performing the procedure...Surgical closure and dressings....there are several general principles that can be applied to the edits as follows: 1. The component service is an accepted standard of care when performing the comprehensive service. 2. The component service is usually necessary to complete the comprehensive service. 3. The component service is not a separately distinguishable procedure when performed with the comprehensive service." The nerve block and closure codes in your example would only be separately reportable if they were unrelated to the bunion procedure done on the same day.