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CCI edit stating 62311 is not allowed with 17000

  1. #1
    Spokane, WA
    Default CCI edit stating 62311 is not allowed with 17000
    Medical Coding Books
    Does anyone have any information as to why CCI has stated that 62311 cannot be billed with 17000 on the same Date of Service. (With a Status Indicator of "0" - no circumstances in which a modifier would be appropriate.)

    These procedures were done for entirely different reasons and on different parts of the anatomy. Has anyone else come across this edit and possibly gotten some info as to CCI's rationale?

    I am educating a provider about this edit and the obvious question will by "why?". It is not unreasonable, in the provider's mind, that these two procedures can be done on the same day -by the same provider. He will want documentation to support this edit and all I can come up with is the actual CCI edit page. It doesn't breakdown the reasoning behind the edit. The provider doesn't want to have the patient come in multiple times to take care of these issues. Also, CCI has allocated the lesser RVU (17000) as the column 1 - comprehensive code, which is even more frustrating to explain to the provider.

    any wisdom out there about this?

  2. Default
    It is possible that CCI is viewing 62311 as a form of anesthetic for the 17000 procedure and is therefore considering it an inclusive component of the procedure?

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