Ophthalmology and Optometry Coding Alert

First round of 2007 edits also deletes 2 C code bundles You don't want to miss several new National Correct Coding Initiative (NCCI) changes that, if ignored, will ensure a speedy denial.

According to Maggie M. Mac, CMM, CPC, CMSCS, consulting manager for Pershing, Yoakley & Associates, Clearwater, Fla., the NCCI edits are just formalizing the code pair associations already spelled out in the new CPT 2007 manual. "And some of it just makes sense in that one code is 'part of' or a component of performing another procedure, so unbundling of the services would be inappropriate."

Most of the NCCI version 13.0 edits that will affect ophthalmology coding involve new CPT code 67346 (Biopsy of extraocular muscle), Mac says. These coding edits reflect the way NCCI previously bundled extraocular muscle biopsy code 67350, which carried the same descriptor as 67346.
 
Tip: Most of the 67346 bundles have a modifier indicator of "1," which means you may be able to report both codes using a modifier, such as modifier 59 (Distinct procedural service), when appropriate.

Bonus: See the chart in this issue for all of the NCCI changes affecting ophthalmology coders for the first quarter of 2007.

Long gone: Of the edits that NCCI 13.0 eliminates, many of the changes include C8952 (Therapeutic/prophylactic/diagnostic IV push), which CPT replaced with 90774 (Therapeutic, prophylactic or diagnostic injection [specify substance or drug]; intravenous push, single or initial substance/drug), and C8950 (Intravenous infusion for therapy/ diagnosis; up to one hour), which CPT replaced with 90765 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour).