Part B Insider (Multispecialty) Coding Alert
What CPT 2004 Gives You, NCCI 2004 Takes Away
New codes are hit hard by January NCCI edits
They're like shiny new toys that someone takes away just when you're getting ready to play with them.
The 2004 CPT manual introduced many new codes, but now the National Correct Coding Initiative edits are making those codes harder to use.
The 2004 edits bundle a number of consultation, emergency care and critical care codes with these new G codes. For example, office and inpatient consultation codes 99243-99251 are components of G0308, and 99251-99254 are components of G0309. A number of other G codes are components of G0327, including medical nutrition codes G0270-G0271, naso/oro gastric tube placement code G0272, angiogra-phy codes G0275-G0278, and injection codes J1642-J1644.
One example is the raft of new codes for central venous access procedures, 36555-36597. All of these codes have a number of other codes bundled into them as components starting in January. A number of gastrointestinal surgery codes become components of 36555-36557.
Meanwhile, a number of liver surgery codes become components of 36557, and kidney surgery codes become components of 36557 and 36558. Also, a number of nervous system surgery codes become components of 36558-36581, and 64449 (Injection ...; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration) became a component of 36582-36597.
CPT codes 36555 and 36556 become mutually exclusive with vascular injection codes 36011-36012 and new venous access codes 36557-36571, plus 36556 is also mutually exclusive with 36013. Codes 36557 and 36558 are mutually exclusive with 36560-36571, as well as each other. A number of the other new codes are also mutually exclusive with each other, and 36595 and 36596 are mutually exclusive with venous embolectomy codes 34401-34490.
Medicare also introduced two new G codes for complete blood count testing, G0306 and G0307, and a number of end-stage renal disease codes, G0308-G0327. The new ESRD codes replace 90918-90921, which have become invalid for Medicare. The new codes enable physicians to bill for ESRD care based on the number of visits provided per month.
Part B Insider (Multispecialty) Coding Alert
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