CCI 16.1: This Electrophysiology Edit Deletion Is Official

If you’ve been holding study claims, the time to send them in is here.

Correct Coding Initiative (CCI) version 16.1 has the news you’ve been waiting for.

The latest version, effective April 1, deletes 142 edit pairs, Frank D. Cohen, MPA, MBB, senior analyst with MIT Solutions Inc. in Clearwater, Fla., reported in a March 22 announcement.

Most importantly: As expected, CCI deleted the edits mistakenly added Jan. 1 that blocked payment for recording, pacing, and electrophysiology (EP) studies performed on the same date of service as an intracardiac catheter ablation procedure (see chart).

Adding potentially delayed EP payments to Medicare’s 2010 fee cuts did not equal good news, as Jennifer Crowell, CPC, CCC, CEMC, lead hospital coordinator for Spokane Cardiology in Washington, pointed out. And the edits had a modifier indicator of “0,” so there was no way to override them to receive payment. (See Cardiology Coding Alert, Vol. 13, No. 1, “Red Alert: Expect EP Study + Ablation Denials Until April 1,” for more information.)

Stake Your Claim for EP Pay

Act now: CCI lists the deletions with a modifier indicator of “9” and shows Jan. 1, 2010, as both the effective and deletion dates, both of which indicate the deletion is retroactive to the effective date. That means if you’ve been holding your claims or have gotten denials because of the erroneous edits, you may now submit the claims for payment.

@ Cardiology Coding Alert, Editor: Deborah Dorton, JD, MA, CPC

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