Ob-Gyn Coding Alert

With the new year comes a voluminous Correct Coding Initiative (CCI) version 15.0, but you don't have to panic applying new coding policies -- your ob-gyn practice needs only to follow the guidelines CPT 2009 adds.

Key: -Almost all of the deleted CCI edits represent deleted CPT codes and not a change in policy,- says Melanie Witt, RN, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.For instance, CPT 2009 deleted codes 0031T (Speculoscopy) and 0032T (Speculoscopy with directed sampling). You-ll find instructions to code either procedure using 58999 (Unlisted procedure, female genital system [nonobstetrical]).

What it is: Speculoscopy represents a magnified chemiluminescent light examination of the cervix and specimen collection. Ob-gyns perform this examination to identify potentially abnormal lesions of the uterine ectocervix for detection of dysplasia (both low and high grade).

Because CPT 2009 crossed out these two codes, CCI 15.0 deleted the former bundling of these two codes into colposcopy codes 57420-57461.

-The sole exception for ob-gyn coding is that code +57267 (Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site [anterior, posterior compartment], vaginal approach [List separately in addition to code for primary procedure]) is no longer bundled with code 57285 (Paravaginal defect repair [including repair of cystocele, if performed]; vaginal approach),- Witt explains.

-This is great news for uro/gyn practices because the vaginal paravaginal repair frequently requires mesh to support the weakened anterior vaginal wall -- just as an anterior colporrhaphy would,- Witt says.

Rationale: CCI deleted the edit because CPT 2009 added code 57285 to the list of procedures that you can report with the add-on mesh code. In other words, -it means that practices which perform these two procedures together can now capture fair reimbursement for both,-Witt says.

Bottom line: That's an increase of $266, based on national averages.

CPT 2009 brought renumbered infusion and injection codes (96360, 96365, 96372, 96374, and +96375), and CCI 15.0 responds by bundling these codes into all urology, gyn, and ob procedure codes, as well as all observation, hospital, emergency department, inpatient consultation, and critical care E/M services.

-These are not new edits per se, as the old codes representing these services were bundled in previous CCI versions,- Witt says. They carry an indicator of -1- which means the bundle can be bypassed with the appropriate modifier if the criteria for using than modifier are met (such as modifier 59, Distinct procedural service).