Neurology & Pain Management Coding Alert

National Technical Information Services (NTIS) has released version 8.2 of the national Correct Coding Initiative (CCI), which lists over 17,000 code-pair additions (i.e., new edits) and 3,700 code-pair deletions. The third-quarter revision for 2002 takes effect July 1 and contains few changes aimed at neurology procedure coding. What's New? Although most revisions in version 8.2 of CCI involve the bundling of anesthesia procedures (00100-01999) to codes not typically reported by neurology practices, several changes including anesthesia codes will affect neurologists: The procedures described by 51784 (Electromyography studies [EMG] of anal or urethral sphincter, other than needle, any technique), 51785 (Needle electromyography studies [EMG] of anal or urethral sphincter, any technique) and 51792 (Stimulus evoked response [e.g., measurement of bulbocavernosus reflex latency time]) now bundle (i.e., include as not separately reportable) anesthesia code 00910 (Anesthesia for transurethral procedure [including urethrocystoscopy]; not otherwise specified]).

Similarly, 93660 (Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention) now bundles anesthesia code 00410 (Anesthesia for electrical conversion to arrhythmias). Note: Code 93660 now also bundles electrocardiogram (ECG) procedures 93000, 93005 and 93010. Like version 8.1, version 8.2 of CCI includes new bundles involving motion analysis codes 96000-96004. Each of these procedures (96000, 96001, 96002, 96003 and 96004) now includes 97116 (Therapeutic procedure, one or more areas gait training [includes stair climbing]) Accordingly, gait training cannot be separately reported with motion analysis. Code-Pair Deletions In a reversal of the usual order, version 8.2 of CCI contains more deletions relevant to neurology practice than additions, although the number is still small and the relative importance of the edits minor. Biopsy codes 20200 (Biopsy, muscle; superficial), 20205 (... deep) and 20206* (Biopsy, muscle, percutaneous needle) no longer bundle codes 88170 and 88171, which were removed from CPT in 2002.

All remaining changes involve the unbundling of simple procedures from anesthesia codes. For example, intravenous infusion therapy (90780 and 90871) are no longer included in anesthesia procedures 00850, 00855, 00857, 00884, 00946 and 00955. Similar "unbundling" edits affect therapeutic injection codes 90782 and 90783. Finally, 95955 (Electroencephalogram [EEG] during nonintracranial surgery [e.g., carotid surgery]) has been unbundled from all of the above anesthesia procedures, as well as 01904, 01906, 01908, 01910, 01912, 01914, 01918 and 01921.