Radiology Coding Alert

Edits enforce current rules

If you need to know how to handle the Correct Coding Initiative (CCI) edits for radiology in version 17.1, just remember: Follow CPT guidelines, and you'll be fine.

Many of the new bundles, effective April 1 for physicians, bundle angiography supervision and interpretation (S&I) codes into transcatheter service codes. The edits will help keep your coding in line with CPT guidelines to use specific radiology codes with certain procedures and to include radiology services in certain codes.

For example: A note under 37204 (Transcatheter occlusion or embolization ...) tells you to use 75894 (Transcatheter therapy, embolization, any method, radiological supervision and interpretation) for any related radiological supervision and interpretation (S&I). So you shouldn't be surprised to see edits preventing you from reporting radiology codes 75600-75660 and 75705-75756 with 37204.

The table below shows many of the new edits most relevant to you. Note that all of the edits below have a modifier indicator of 1. That means you may override the edit with a modifier in appropriate circumstances, such as reporting each code in the edit for a distinct service.

Resource: You can download the CCI edits from www.cms.gov/NationalCorrectCodInitEd/.