Tag Archives: 94250

What Interventional Radiology Coders Should Know About CCI 15.1

Posted on 16. Apr, 2009 by .

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EXTRA–Radiology Reimbursement WEBINAR: Do you know the difference between ‘Radiologic Technologist’ & RPA? Find out the answer–and how it affects your billing–here.

With 304,000 new edits Correct Coding Initiative (CCI) version 15.1 put into effect April 1, finding the ones that apply to interventional radiology is like finding the proverbial needles in the haystack. And now, slapping modifier 59 on every claim is more tempting than ever.

Careful: Many practices apply modifier 59 (Distinct procedural service) indiscriminately to bundled pairs to override the edits. But misusing modifier 59 this way is a serious compliance issue, leading to a high likelihood of audit and risking fraud charges, according to Frank Cohen, MPA, senior analyst with MIT Solutions Inc. in Clearwater, Fla., in his March 25, 2009 webinar.

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CCI 15.1: Adhere to These Osteotomy, Laminectomy Edits

Posted on 08. Apr, 2009 by .

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You’ll need a modifier on this code pair to bust bundle.

Be cautious about reporting a same-session spinal osteotomy with a laminectomy due to the new edits the Correct Coding Initiative (CCI) version 15.1 unloads.

First, Take a Large Picture View

Version 15.1, effective April 1, contains 304,038 additions. “The file is one of the largest I’ve seen,” says Barbara Cobuzzi, MBA, CPC, CENTC, CPC-H, CPC-P, CIMC, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J.

AUDIO TRAINING EVENT: Neurosurgery Modifiers Made Easy, with Suzanne Leder.

The official reason CMS has given for the size is a need to control anesthesia bundles.

Spot Where Most New Edits Pop Up

Despite the numerous edits, CCI aims its fire at a select few codes this round, with only 524 unique codes listed in column 2 of the new column 1/column 2 edit

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News Flash: Over 300,000 New Code Pair Edits from CCI

Posted on 25. Mar, 2009 by .

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Extra! CCI also creates a few welcome deletions.

If you thought CCI versions after January were pretty tame, get ready for a big surprise.

The Correct Coding Initative’s (CCI’s) version 15.1, which goes into effect on April 1, adds over 304,000 new edit pairs to its already massive list.

On the radar: CCI aims its fire at a select few codes this round, with only 524 unique codes listed in column 2 of the new column 1/column 2 edit list, and “only 48 codes make up the top 80 percent” of those listed, said Frank Cohen, MPA, senior analyst with MIT Solutions, Inc. in Clearwater, Fla., in a March 12 news release.

Extra, Extra! CCI Meets UHC. Get your tools for survival here.

The top most commonly-occurring codes in column 2 of the new non-mutually exclusive edits are 94250 (Expired gas collection, quantitative), 94680-94690 (Oxygen uptake, expired gas analysis), 95812-95819…

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