Decipher what column 1/column 2 means in this neurosurgery bundle example.
Question: Would you explain what the differences are between mutually exclusive and “column 1/column 2″ edits that come from the Correct Coding Initiative (CCI)?
Florida Subscriber
Answer: Mutually exclusive…
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….
Keep tabs on details to help justify more extensive treatments later.
Plantar fasciitis — a condition in which the plantar fascia becomes inflamed and painful — is the most common form of heel pain and can be treated many different…
Upcoming policy change will slash your payments by half.
Big changes are on the horizon if you participate with insurance provider Horizon Blue Cross Blue Shield (BCBS) of New Jersey.
In a recent memo, BCBS states that effective May 17,…
CMS won’t fix CCI blunder until version 16.1, to be released in the spring.
If your heart skipped a beat when you saw that January’s Correct Coding Initiative (CCI) edits bundled catheter ablations with electrophysiology (EP) studies, you weren’t alone.
Good news: CMS has decided to delete the edits retroactively because their addition was a mistake, according […]
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Don’t sweat reporting 38220-59 if you meet these Medicare-approved conditions.
If your oncologist takes both a bone marrow biopsy and a bone marrow aspiration, whether you’ll see Medicare reimbursement depends on the two guidelines below. But watch out: With OIG scrutiny and a HCPCS twist, these guidelines will put your coding savvy to the test.
Append 59 […]
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Check your EOB to make sure payers don’t apply a multiple-procedure reduction to +69990.
Question: When my ENT uses a microscope during a procedure, what guidelines can I use for choosing between 92504 and +69990? Is there a rule governing how many times you can report the add-on code 69990?
Answer…
You can use 92504 (Binocular microscopy [separate […]
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Here’s where you can bypass the edits with modifier 59.
The Correct Coding Initiative (CCI) version 16.0 didn’t overlook the hysterectomy, vaginal graft, and colpopexy codes — nor should you. To make sense of the deletions, break these additions into mutually exclusive and non-mutually exclusive.
Note: In all these cases — except those involving the anesthetic injection […]
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Determine ‘planned or unplanned’ before separately coding vitrectomy.
With several possible surgical treatments for cataract procedures, which you probably code more often than any other surgery, there’s a lot of room for error – with over $890 at stake for complex cataract procedures in 2009.
Use these tricky scenarios as a guide through some of the most […]
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Don’t bank on accepted 88321-88323 unit of service.
Your pathologist consults with an outside lab on slides taken from a 2006 lumpectomy and a 2009 lymph node fine needle aspiration (FNA). That’s 88321 x 2 — right?
Maybe. Your payer determines the answer to that question.
The problem: “Although the American Medical Association (AMA) says the unit of service for […]
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