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CCI Quarterly Update
Take care when reporting lesion destruction codes with other skin procedures because the latest quarterly update to the National Correct Coding Initiative (CCI), effective July 1, includes a number of new code pairs involving those codes.
You stand to lose at least $20 per claim that your practice bills 99211 with venous blood draw (36415) services performed on the same day because of new Medicare coding rules.
If you plan to report a surgical or medical procedure on the same date as a transitional care management (TCM) code (99495-99496), check first to see whether the TCM codes are bundled or you may face denial of the 30-day service code.
You’ll contend with a little under 1,300 new Correct Coding Initiative (CCI) edits beginning Oct. 1, a relatively light batch of changes for the end of the year, according to a DecisionHealth analysis of the changes in CCI version 19.3. With new CPT codes coming in January, you’ll likely have a bigger batch to contend with at the start of 2014.
If you haven’t worried much about denials when reporting E/M codes with your surgical procedures because no National Correct Coding Initiative (CCI) edits bundled them — here’s a heads up: Now they do. In the July 1 quarterly update to CCI (version 19.2), you’ll find nearly 300,000 new code pairs. Almost all of them bundle E/M codes into thousands of surgical and medical procedure codes.

CMS’ latest National Correct Coding Initiative (CCI) edits effective April 1 are far more modest than in recent quarters. But some specialties, such as cardiology, will see noteworthy new limits on what can be billed together. The new list contains 744 new code pairs, compared with almost 40,000 last quarter and 250,000 in Q4 2012.

Coders will have to get familiar with nearly 40,000 new code pairs – far fewer than the 250,000 released in 2012’s fourth quarter – in CMS’ latest National Correct Coding Initiative (CCI) edits effective Jan. 1, 2013.
The biggest group of added edit pairs were about 11,000 comprehensive codes in the 90000 code range, relating to transitional care services including hospital care, transportation, home health and CMS’ new transitional care management (TCM) codes for newly discharged patients. 

Coders  will have to get familiar with nearly 250,000 new code pairs – a hundred times more than were released in the third quarter – in CMS’ latest National Correct Coding Initiative (CCI) edits effective Oct. 1. The majority of added edit pairs have been comprehensive codes in the 20000 code range, relating to general surgery and trigger point injections.

Coders will have a tougher time getting paid for preventive services, such as alcohol screening, now that CMS has bundled several screening services with office visits in its National Correct Coding Initiative (CCI) edits that were effective July 1.

Primary care practices could get a little extra money due to deleted edits that led to reimbursement changes in the latest National Correct Coding Initiative (CCI) edits.  But most practices -other than neurosurgery, orthopedic, urology and oncology specialties -won’t see major code pair changes in 2012’s second quarter.



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