Ob-Gyn Coding Alert

Question: I know the National Correct Coding Initiative (NCCI) edits usually come out January 1. Did I miss anything my ob-gyn practice should I know?

Texas Subscriber

Answer: Several ob-gyn edits were included in the latest NCCI version, effective Jan. 1, 2023.

First, all the abdominal anterior hernia repair codes (49591- 49618) and the two codes for repair of a parastomal hernia (49621-49622) have been bundled into all of the abdominal hysterectomy codes (58150-58210) and the code for pelvic exenteration (58240), but you can use a modifier to bypass the edit if the requirements are met. These bundles were assigned based on “standards of medical/surgical practice.”

Second, the code for a laparoscopic prostatectomy (55867) is now permanently bundled with the pelvic extent code (58240) based on it being a misuse of a column 2 code with a column 1 code. This means you cannot use a modifier to bypass this edit. Keep in mind that while this bundle seems to make no sense, Centers for Medicare & Medicaid Services (CMS) add bundles when two codes are incorrectly bundled at least 5 percent of the time.