Medicare Compliance & Reimbursement

Correct Coding Initiative:

Get To Know The New CCI 16.1 Code Bundles, Or Risk Unexpected Denials

New edits in spine, urology, catheterization, pathology, and other specialties could change how you submit your claims. With the release of Correct Coding Initiative (CCI) version 16.1, you might be wondering what's in store for you among the 2,054 new code pairs. Read on for a sampling of the coding edits that went into effect April 1. • Spine: The CCI will now bundle 22856 (Total disc arthroplasty) into all of the codes in the arthrodesis/kyphectomy series 22804--"22819. You can use a modifier (such as 59, Distinct procedural service) to separate these edits if both services were performed as distinct procedural services. • Injections: You'll find injection code 96372 (Therapeutic, prophylactic, or diagnostic injection) bundled into over 30 codes from the radiology section, including aortography codes 75600--"75630. You can use a modifier to separate these edits. • Urology: You can no longer report prostate biopsy codes 55700 or 55706 with [...]
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