Advanced Search

Oncology & Hematology Coding Alert

Reader Question:

79005 and More Saw CCI 17.1 Changes

Published on Wed Sep 07, 2011

Question: I've been hearing that a lot of the April CCI nuclear medicine updates changed modifier indicators retroactive to January. Does that mean we can resubmit the claims for payment?Maryland SubscriberAnswer: When Correct Coding Initiative (CCI) edits are modified or deleted retroactive to a specific date, you may resubmit claims denied because of the edit when the date of service is on or after that specific date.Regarding version 17.1's retroactive changes to modifier indicators for nuclear medicine edits, the column 1 codes involved all describe radiopharmaceutical therapy. The column 2 codes describe radiopharmaceutical imaging, uptake, and tumor localization, along with patency test code 78291 (Peritoneal-venous shunt patency test [e.g., for LeVeen, Denver shunt]).The change is retroactive to Jan. 1, 2011, so you may resubmit claims denied because of the edits for dates of service between Jan. 1 and March 31.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All