Primary Care Coding Alert

CCI:

0228T, 0230T Play Big Role in CCI 16.3 Edits

Only report primary procedure -- except for 99455 edits.The latest version of Correct Coding Initiative (CCI) edits went into effect October 1, and introduced a slew of pairings involving new Category III "T" codes for transforaminal epidural injections. Edits affecting family physicians involve two of these new codes:0228T -- Injection(s), anesthetic agent and/or steroid,  ransforaminal epidural, with ultrasound guidance,cervical or thoracic; single level 0230T -- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; single level.Explanation: "The new Category III codes 0228T-0231T have added the addition of ultrasound guidance to transforaminal epidural injections," says Susan Vogelberger, CPC, CPC-H, CPC-I, CMBS, CCP-P, CEO of Healthcare Consulting and Coding Education in Boardman, Ohio. "That will eliminate the need to code the ultrasound independently." The existing, Category I codes for transforaminal epidural injections of anesthetic and/or steroids (64479-64484) include only the injection itself. Although family physicians might not administer transforaminal epidurals every [...]
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