Dermatology Coding Alert

There's no reason you would ever have to bill two "new patient" office visits by the same patient on the same day, but now you won't be able to anyway.

NCCI is bundling each new patient visit code from 99201-99205 (Office visit for the evaluation and management of a new patient ...) with every lower-level code in the same series. You can't use a modifier to override those edits.

In addition: The same goes for initial observation codes 99218-99220, inpatient consultation codes 99251-99255, domiciliary/rest-home visit codes 99324-99337, and home visit codes 99341-99345.

Also, subsequent hospital care codes 99231-99233 are all bundled with initial inpatient service codes 99221-99223, and no modifier can override those edits either. You also can't bill two different subsequent hospital visit codes for the same patient on the same day.

More new edits to pay attention to:

• Debridement codes 11000 and 11040 will become components of dressing codes 16020-16030. Also, intralesional injection codes 11900-11901 will become components of chemotherapy codes 96401-96450 and 96542.

• Fascia lata graft codes 20920-20922 and tissue graft code 20926 will become components of blepharoptosis repair codes 67901-67902.

• Proctopexy codes 45400-45402 and 45540-45550 and proctectomy code 45397 become components of colectomy codes 44140-44156, 44160, 44204 and 44206-44212.

You can override all but a few of these edits with a modifier.

• Manipulation codes 45900-45915 become components of chemodenervation code 46505 and ileoanal pouch repair codes 46710-46712.

• Code 57410 for pelvic exam under anesthesia becomes a component of 51 codes for female genital system surgery. You can't use a modifier to override any of these edits.

• Molecular diagnostic testing codes 83900 and 83907-83909 become components of infectious agent detection codes 87470-87801 and 87901-87904, except for four codes introduced in 2007.

• Needle electromyography codes 95860-95870 and six other neurology testing codes become components of chemodenervation codes 64650-64653.