Urology Coding Alert

The new edits also change how you code bladder instillation, kidney transplant prep, and PVR measurements The latest Ncci Edits have the answers you have been looking for since the release of the new 2005 CPT Codes: what you can - and can't - report with all the new Fournier's debridement and kidney transplant preparation CPT codes.

The first set of National Correct Coding Initiative edits for 2005, version 11.0, includes guidance on how to report the new ureteral instillation and Fournier's debridement codes (see "CPT 2005 Update: Ring In the New Year With 3 New Fournier's Debridement Codes" in the November 2004 issue of Urology Coding Alert), as well as some surprises for ureterography injections and postvoid residual (PVR) measurements.

Reminder: These NCCI edits went into effect Jan. 1, 2005. Break Fournier's Bundles With Modifiers Urologists and urology coders rejoiced when they saw the new codes for debridement of Fournier's gangrene in the 2005 CPT manual. CPT codes 11004 (Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum), 11005 (... abdominal wall, with or without fascial closure) and 11006 (... external genitalia, perineum and abdominal wall, with or without fascial closure) are a vast improvement over the low-paying 11040-11044 series (Debridement; skin ...) coders were previously forced to report. The honeymoon is over, though: Codes 11004-11006 now include the following procedures, according to version 11.0:
   11000 - Debridement of extensive eczematous or infected skin; up to 10 percent of body surface
   36000 - Introduction of needle or intracatheter, vein
   36410 - Venipuncture, age 3 years or older, necessitating physician's skill (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)
   37202 - Transcatheter therapy, infusion other than for thrombolysis, any type (e.g., spasmolytic, vasoconstrictive)
   Diagnostic or therapeutic injection codes 62318-62319
   Nerve block injection codes 64415-64417
   Anesthetic agent injection codes 64425-64470 and 64475.
 
NCCI has assigned these bundles a status indicator of "1," allowing you to break the bundles with a modifier under certain clinical circumstances. Code 11006 also includes codes 11004 and 11005; those bundles are also marked with modifier indicator "1."

Exception: You may not unbundle 01995 (Regional intravenous administration of local anesthetic agent or other medication [upper or lower extremity]) from  11004-11006, because they are marked with modifier indicator "0." Codes 11004-11006 also include the operating microscope code 69990.   Adrenalectomy Included in New Backbench Code According to the latest set of NCCI edits, the 2005 code for kidney preparation for transplant (50323, Backbench standard preparation of cadaver donor renal allograft prior [...]