General Surgery Coding Alert

Surgery coders may soon face an additional layer of guidelines, because the AMA, which oversees the creation of CPT codes, might develop its own version of the National Correct Coding Initiative (NCCI).

CPT guidelines have always specified codes that you shouldn't bill together, or codes that you must report as add-ons, for example. But, this June, the AMA plans to take an additional step and report to its House of Delegates on the results of a resolution the delegates passed last summer. The resolution calls on the AMA to study "the feasibility of developing a national standard for the utilization of codes, code combination, and modifiers that is consistent with all CPT codes, guidelines, and conventions, and that would be used by all commercial and governmental payers."

An AMA correct coding initiative could provide invaluable guidance to coders, but it will mean an additional layer of bundling guidelines over and above those already mandated by CMS with the NCCI. Look to General Surgery Coding Alert in the months ahead for more information on this topic.