Wiki 63052 with 22633 Edits

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KZA had an article about this at the end of June:

"KZA contacted the relevant specialty societies who. in turn, immediately contacted Medicare's NCCI officials. The outcome? NCCI admits that this edit was published in error and will be rescinded as soon as possible, but likely not until the next quarterly publication of NCCI edits on January 1, 2024."

What does this mean for your practice?
  • Medicare payors and payors who follow Medicare edits will likely deny codes 63052 and 63053 when reported with codes 22630, 22633, 22632, 22634 respectively effective 7/1/23.

What should you do?
  • Continue to report 63052 and 63053 with the lumbar interbody arthrodesis codes listed above whenever additional decompression is documented at the same interspace
  • Tag and track all cases that have this code combination
  • When NCCI rescinds (deletes) the edit, reimbursement will be retroactive to 7/1/23. Your practice will need to identify all cases billed between 7/1/23 and the edit deletion for either resubmission for payment or possibly automatic reimbursement for all cases"
 
Has anyone seen the NCCI publication explaining the error for 63052 with 22633?? Karenzupko states to appeal commercials using it but I can't find it. I found the lab one but not this one. Can anyone send me this link? Please and thank you.
 
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