Neurosurgery Coding Alert

Edits switch columns for polysomnography, needle EMG pairs.

If your practice reports polysomnography with needle EMG services, note that CCI 16.2 reverses some Column 1 and Column 2 codes.

Note: When CCI pairs codes as "mutually exclusive procedures," you can't report those two procedures during the same patient encounter. Always submit the "Column 1" code of the pair, as submitting the "Column 2" choice can lead to denials.

The four relevant code pairs in CCI 16.2 are below, so update your software or coding notes accordingly:

Whether you can submit both codes for the encounter depends on whether CCI assigns a "0" or "1" modifier indicator to the pair.

"0" modifier indicator means you should never report both codes together. "1" modifier indicator means you can report both codes under certain circumstances and with enough supporting documentation. You'll append one of the CCI-associated modifiers such as modifier 59 (Distinct procedural service) to the Column 2 code, thus unbundling the edit and allowing payment for both services.