Cardiology Coding Alert

Review modifier changes and column swaps for the full picture.

Correct Coding Initiative (CCI) 18.3, effective Oct. 1, 2012, is not short on changes -- more than 230,000, according to the NCCI 18.3 Update posted by Frank Cohen, MPA, MBB, principal and senior analyst for The Frank Cohen Group.

A large number of the edits focus on integumentary system codes in the 10000 range, so they shouldn't affect your day-to-day coding.

But the latest edits also make it clear that you need to think twice before reporting temporary pacemaker codes 33210 (Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter [separate procedure]) and 33211 (Insertion or replacement of temporary transvenous dual chamber pacing electrodes [separate procedure]).

You'll find hundreds of edits for these codes with a modifier indicator of 0, which means you can't override the edit using a modifier. Hundreds of previously existing edits with 33210 or 33211 in the column 2 position have been updated to change the modifier indicator to 0 from 1 (the 1 meant that you could override the edit).

In a couple of cases, the modifier indicator changed and the columns swapped, too. Specifically, instead of bundling 33210 and 33211 into 92961 (Cardioversion, elective, electrical conversion of arrhythmia; internal [separate procedure]), CCI now bundles 92961 into the temporary PM codes.