Part B Insider (Multispecialty) Coding Alert

940 edits bundle many procedures with new skin graft codes

CPT 2006 introduced four new codes for laparoscopic gastric procedures, 44180-44188 (See PBI, Vol. 6, No. 38.) And now the Correct Coding Initiative will make those new codes much harder to use.

CCI 12.0, effective January 1, makes a number of codes into components of 44180-44188. These include IV introduction code 36000, venipuncture code 36410, trans-catheter therapy code 37202, tube placement code 43752, laparoscopy code 49320, spinal injection codes 62318-62319, anesthetic injection codes 64415-64417, 64450-64470 and 64475. You'll be able to use a modifier to override all of these edits except the one for operating microscope, code 69990.

Also, 44180 becomes a component of a shocking 447 codes, including almost every code in the stomach, intestinal, liver, biliary tract, pancreas and abdominal surgery section, plus almost all the intestinal repair codes. Most of these edits will allow you to use a modifier to override them, but a large number can't be overridden.

And 44180 becomes a component of many codes for aneurysm repair, abdominal blood vessel repair, splenectomy, lymphadanectomy, appendix surgery, urinary system surgery, bladder surgery, testis surgery and female genital system surgery. It also becomes a component of diaphragm repair codes 39401-39503 and 39530-39545, excision codes 43101-43124, laparoscopy code 43280, esophagoplasty codes 43320-43350, 43360-43415 and 43425, rectum excision codes 45110-45126 and 45135-45136, and rectum repair codes 45540-45825.

Also in CCI Version12.0:

• New codes 33880-33886 for endovascular repair of descending aorta become mutually exclusive with thoracic aortic aneurysm repair codes 33870-33875. You can override those edits with a modifier, but not an edit making 33880 and 33881 mutually exclusive, or edits bundling 33886 with 33880-33881. Also, 15 codes each become components of 33880-33886.

• The new skin graft codes (except for add-on codes) have dozens of procedure codes bundled into them, in 940 new edits. You can override these edits with a modifier except for the ones targeting anesthesia codes 01951-01952.

• Some 536 edits bundle new conscious sedation codes 99148-99149 with many anesthesia codes, and you can't use a modifier to override those edits.

• New code 96523 (Irrigation of implanted venous access device for drug delivery systems) becomes a component of 109 codes, including chemotherapy administration codes and evaluation and management codes. You can't use a modifier to override those edits. Also, new pump maintenance codes 96521-96522 become components of several codes, including chemotherapy codes, but you can override those edits.