Medicare Compliance & Reimbursement

The Correct Coding Initiative (CCI) may have startled coders when its April 1 round of edits bundled applied neurostimulator code 64550 into hundreds of other procedures, but new version 15.2 corrects that error, deleting these bundles retroactive to April 1, 2009.

The new version of CCI, which took effect July 1, does bundle 64550 (Application of surface [transcutaneous] neurostimulator) into several anesthesia codes (such as 01920 and 01922), "but this is nothing considering that code was bundled into practically every other code in CPT prior to the new CCI deletions," says Atlanta-based coding consultant Jay Neal.

Anesthesia affected: Of the 3,565 new edit pairs, a full 65 percent of the column 1 codes are in the 00100-01999 range, according to analysis by Frank Cohen, senior analyst with MIT Solutions, Inc. This means that more services than ever are bundled into anesthesia codes.

IV push: You'll now find code +96376 (Therapeutic, prophylactic, or diagnostic injection; each additional sequential intravenous push of the same substance/drug provided in a facility ...) bundled into most of the radiology codes and some of the echocardiography codes.

Mutually exclusive: CCI created just six new mutually exclusive edits, now bundling E/M codes 92002, 92012, and 92014 into eye exam codes 92018 and 92019. You cannot use a modifier to separate these edits.

Plus: Eye exam codes 92018 and 92019 also now bundle into most of the eye surgery codes. You can, however, use a modifier to separate these edits.

Swapped pairs: You'll find several edit pairs that have leaped from column 1 to column 2, and vice versa. For example, several of the E/M codes (such as 99201-99215) were bundled into code 94662 (Continuous negative pressure ventilation, initiation and management) in the past. Effective July 1, 94662 will instead be bundled into the E/M codes.