Pediatric Coding Alert

Other than fine need aspiration coding, you're in the clear in terms of CCI edits.

If new editions of the CCI strike fear into your pediatric practice, you can rest easy because the latest version of it won't hurt your revenue too dramatically. CCI version 17.2, which takes effect July 1, offers 2,367 new edit pairs and deletes 336 bundles, according to an analysis by Frank Cohen, MPA, MBB, principal and senior analyst with The Frank Cohen Group, LLC. The majority of edits impact the codes from the musculoskeletal code range (20000-29999), but bundles did occur to codes throughout the CPT® manual.

For instance: Although the CCI previously appeared to do a thorough job of bundling fine needle aspiration (FNA) codes 10021-10022 into most biopsy, excision, and resection codes, the new version of CCI takes it a step further. Effective July 1, you'll find these FNA codes bundled into scores of additional musculoskeletal procedures, from the 24071-24079 range (Upper arm excision/resection) to the 26250-26262 range (Finger resection) and beyond.

If the physician can provide documentation that the FNA and other procedure were for separate sites (separate lesions or masses), you can code both services. In that case, you would need to override the CCI edit pair by appending a modifier such as 59 (Distinct procedural service) to the FNA code.

To read more about CCI coding, visit the CMS Web site at www.cms.gov/NationalCorrectCodInitEd/.