Part B Insider (Multispecialty) Coding Alert
Anesthesiologists Will Feel Pain From NCCI
If you're billing for anesthetic injection services with dozens of surgery codes, you can expect to have a fight on your hands after July 1. Fracture Repair Codes Knitted Together With Edits Another change in the new NCCI edits makes it much harder to bill for a cast or splint at the same time as a fracture repair. "When coding a fracture repair, it is rare that a casting or splinting code is going to be used at the same time," Verno says.
The National Correct Coding Initiative version 9.2, which takes effect next month, includes 3,809 edits, among them many that will make separate reimbursement for anesthesiologists much harder. A quartet of anesthetic injection codes (62311, 64430, 64435 and 64483) become components of 45 different codes in nonmutually exclusive edits.
"Anesthesiologists will have a heart attack when they see their codes considered as part of the surgical codes," says Steve Verno, director of reimbursement with Emergency Medicine Specialists in Hollywood, Fla. "But when you look at the reality of it, you cannot perform these procedures without anesthesia."
Try to bill for those codes with surgery codes, and the carriers will respond that anesthesia is included in those surgical procedures. Those four codes will become components of:
A number of fracture repair codes (23500-23575, 24500-24685, 25500-25695, 27193-27266) are now bundled with a number of cast and splint codes (29000 to 29590) in nonmutually exclusive edits. In other words, the cast and splint codes will be considered a part of the fracture repair and denied unless you use a modifier to justify them.
Part B Insider (Multispecialty) Coding Alert
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