Help is here: One troublesome, confusing edit is no longer an issue.
You may still be getting to know your CPT 2010 manual, but the new edition of CCI, effective April1, is already looking to make some code pairings impossible.
The Correct Coding Initiative (CCI) released version 16.1 earlier this week, revealing 2,054 new active pairs and 1,947 modifier changes, said Frank D. Cohen, MPA, MBB, senior analyst with MIT Solutions, Inc., in a March 22 announcement.
Deletions: CCI version 16.1 attempts to untangle several troublesome sets of edits in its next round with the announcement that 142 code pair bundles will be deleted, Cohen noted. For instance, CCI previously bundled 93610 (Intra-atrial pacing) and 93612 (Intraventricular pacing) into 93651 (Intracardiac catheter ablation …), but effective retroactive to Jan. 1, that bundle has been deleted.
Swapped pairs: In the past, CCI used to bundle shoulder arthroscopy code 29806 into shoulder surgery code 29825. Essentially, CCI denied 29806 when billed with 29825, unless you appended a modifier. However, CCI has just announced that it plans to “swap” the pairs, and will now bundle 29825 into 29806.
“I believe this edit makes sense,” says Ruby Woodward, BSN, ASC-OR, coding and research specialist for Twin Cities Ortho-pedics, PA in Minneapolis, Minn. “Generally, if we are doing a capsulorrhaphy, we are doing it for instability, which is probably a greater issue. If a patient has a true ‘frozen shoulder,’ which would be the primary reason to do 29825, they wouldn’t be unstable.”
Modifier changes: CCI will now allow you to append a modifier to separate the edits bundling 64450 (Injection, anesthetic agent, other peripheral nerve or branch) into hundreds of other codes, such as debridement codes 11004-11006. The modifier indicator in these code pairs used to be “0,” indicating that nothing could separate the edits, but with CCI version 16.1, the indicator is now “1,” meaning you can append a modifier (such as 59, Distinct procedural service) to the code.
Although most of the modifier indicator changes involve 64450, CCI also changes the modifier indicator bundling new code 88738 (Hemoglobin) into 85025-85027 (Complete CBC). Effective April 1, you can use a modifier to separate these bundles.
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