Neurology & Pain Management Coding Alert

Also:  Get up to speed on the most sweeping new bundle of 2006

If you-re having difficulty understanding how to use the new chemodenervation guidance add-on codes, NCCI version 12.0 will help to keep your coding on track.

The edits list +95873 (Electrical stimulation for guidance in conjunction with chemodenervation) and +95874 (Needle electromyography for guidance in conjunction with chemodenervation) as components of needle electromyography codes 95860-95870.

No surprises: This group of bundles solidifies the instructions you-ve already received in CPT's parenthetical notes. -In reviewing the 2006 CPT changes, guidelines specifically state that you should not report the add-on codes with 95860-95870,- says Barbara Shapiro, CPC, practice manager of Summit Neurological Associates Inc., in Baberton, Ohio. Instead, you should only use these add-on codes to report guidance with chemodenervation codes 64612-64614.

To make sure that you have kept up with the addition of the new codes, NCCI 12.0 rules out the possibility of reporting guidance for chemodenervation procedures using 95870 (Needle electromyography; limited study of muscles in one extremity or non-limb [axial] muscles [unilateral or bilateral], other than thoracic paraspinal, cranial nerve supplied muscles or sphincters).

Before CPT introduced the new add-on codes, neurology coders reported guidance for limited studies with 95870, says Marianne Wink-Sturgeon, RHIT, CPC, ACS-EM, coder for the department of neurology at the University of Rochester Medical Center in New York. But the new bundles--marked with an unbreakable 0 status indicator--mean that you-ll no longer be able to report 95870 in conjunction with chemodenervation procedures 64612-64614 and 64640. 

Bundle Therapeutic Injections and Infusions

The most sweeping edits of NCCI 12.0 bundle new intravenous infusion and therapeutic injection codes into more than 5,000 medical procedures. Unless you have a good reason to break these status 1 bundles, you-ll need to cut out separate reporting for the following codes:

- 90760--Intravenous infusion, hydration; initial, up to 1 hour

- 90765--Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

- 90772--Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

- 90774---intravenous push, single or initial substance/drug

- +90775---each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure)

- C8950--IV infusion for therapy/diagnosis; up to 1 hour

 - C8952--Therapeutic, prophylactic or diagnostic injection; IV push

Editor's note: To make sure you-re in the clear when separating status 1 edits, check out -News You Can Use: OIG Cracks Down on Modifiers 25 and 59--Again- later in this issue.