Ob-Gyn Coding Alert

Question: I noticed the Correct Coding Initiative (CCI) version 17.3 came out. Do any of these edits affect ob-gyn practices?

Florida Subscriber

Answer: The only edit impacting ob-gyn practices is the addition of appendectomy codes 44950 (Appendectomy) and 49970 (Laparoscopy, surgical, appendectomy) into most codes. These edits have a modifier indicator of "0," meaning you cannot separate these edit with a modifier (such as 59, Distinct procedural service) for any reason.

To be exact, you'll find 44950 to be the column 2 code for 51990, 51992. 57425, 58541-58554, 58570-58573, and 58661-58673.

Additionally, 44970 is the column 2 code for almost all ob-gyn surgeries: 51840-51845, 57106-57112, 57200-57240, 57280-57289, 57291-57296, 57300-57335, 57530-57531, 57540-57545, 58170-58180, 58200-58240, 58410, 58520, 58540, 58600-58615, 58700-58770, and 58805-58960.

If you try to report one of these appendectomy codes with the listed surgeries, the payer following CCI edits will only reimburse you for the surgery or column 1 code.