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PTP Edits being proposed to the NCCI and OCE

D

dchriw

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Wentzville, MO
HI....I have been given a project that involves looking at group of edits that bundle column two CPT codes describing biopsy procedures into column one CPT codes describing -ectomy procedures. The basis of these edits is that biopsy of a lesion/organ/tissue that is subsequently removed at the same patient encounter is not separately reportable...only the more extensive procedure. What is the best methodology to look at various code sets (O/P and I/P) to give feedback on applicable modifier or not. Example of code set : 58150 (col 1) 57454, 57455, 57460 (col 2) proposed modifier = 0. OR 58262 (col 1) 57454, 57455, 57460 (col 2) proposed modifier = 0.
 
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