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Oncology & Hematology Coding Alert

Reader Questions:

Cheer CCI Change for E/M and Radiation Codes

Published on Wed Jan 27, 2010

Question: Did the January Correct Coding Initiative (CCI) release delete the edits bundling clinical treatment plans and simulations into new and established patient visits? Texas Subscriber Answer: CCI version 16.0 does not delete edits bundling new and established patient E/M visits into clinical treatment plans (77261-77263) and simulations (77280-77295), but it does change the modifier indicator. Before Jan. 1, the modifier indicator for these edits was "0," meaning that you could not override the edit. But the Jan. 1 release changed the modifier indicator to "1," which means you may override the edit using a modifier. How this helps: You previously could report a consult E/M code on the same date as treatment plans and simulations, but CMS no longer covers consult codes, effective Jan. 1. The modifier indicator change allows you to report an appropriate new or established patient E/M in those instances where you used to report a [...]
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