Radiology Coding Alert

Here's what CCI says about reporting new cardiac MRI codes togetherCorrect Coding Initiative (CCI) version 14.0 showers you in new edits, so we've broken down the principles behind the new edits so you can see how they really affect your daily coding. Master these essentials to help avoid the hassle of edit-related denials.1. Target Helpful Info in Slew of New EditsCCI edits come out every January, April, July and October. The first CCI edits of the year are often the most numerous. Here's why: CCI must create new bundles for the new codes that go into effect Jan. 1.Case in point: CCI 14.0, effective Jan. 1, bundles new neonatal initial hospital care code 99477 into a whopping 418 codes, says Frank Cohen, CMPA, of CPA Health Partners in Clearwater, Fla. If you report 99477 with scores of radiology codes, Medicare carriers will reject the 99477 charge.More important, CCI 14.0 also offers up multiple nonmutually exclusive (or Column 1/Column 2) edits for new radiology-specific codes, such as these examples for cardiac MRI codes 75557-75564 (Cardiac magnetic resonance imaging for morphology and function ...):Note: "M" stands for "modifier indicator."The first edits of the year may be hefty because they bundle the usual suspects (such as needle introduction) into new codes, but don't get overwhelmed and miss out on helpful guidance on how new codes relate to each other.Example: With the modifier indicator "0," the above edits clarify that you never should report 75559 (Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging) on the same day as 75561 (Cardiac magnetic resonance imaging for morphology and function without contrast material[s], followed by contrast material[s] and further sequences).Remember, "0" means you can't override the edit. But a "1" modifier indicator means you can override an edit with a modifier when appropriate, says Maggie M. Mac, CMM, CPC, CMSCS, CCP, ICCE, consulting manager for Pershing, Yoakley and Associates in Clearwater, Fla.2. Find Support for CPT Guidelines in EditsBundles often back up instructions in the CPT manual not to report two codes together.Case in point: CCI 14.0 creates several new edits that match new instructions in the CPT manual.Consider the following examples:• 3-D rendering codes 76376 and 76377 are bundled into cardiac MRI codes 75557, 75559, 75561 and 75563, supporting the CPT instruction under these codes, "Do not report 75557-75564 with 76376, 76377."• CCI bundles 90773 (Therapeutic, prophylactic or diagnostic injection [specify substance or drug]; intra-arterial) into 79445 (Radiopharmaceutical therapy, by intra-arterial particulate administration), supporting the new instruction, "Do not report 79445 in conjunction with 90773, 96420."• A new edit bundles newly listed code 0175T (Computer-aided detection [CAD] [computer algorithm analysis of digital image data for lesion detection] with further physician [...]