Tag Archives: 94250
Posted on 16. Apr, 2009 by .
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.
Posted on 08. Apr, 2009 by .
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.
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 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.
Posted on 25. Mar, 2009 by .
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.
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 (Electroencephalogram), and 96376 (Therapeutic, prophylactic, or diagnostic injection; each additional sequential IV push), all with 1.67 percent of the total (5,065 occurrences each), Cohen says.