Primary Care Coding Alert

Tip: Exploration and drainage codes override some biopsy or synovectomy choices.The latest edits from the National Correct Coding Initiative (CCI) went into effect April 1, and contain some arthrotomy pairings that FP offices should check out. The affected arthrotomy codes include: 26075 -- Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each 26080 -- Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each 28022 -- Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint 28024 -- Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint. CCI 17.1 considers the arthrotomy procedures part of non-mutually exclusive edits, meaning a physician might carry out the procedures during the same care session, but the procedures aren't typically reported together. One of the codes (the component code) is considered to be included in the services represented [...]