CCI Edits 18.0: Get Well-Versed with New Bundled Codes

Plus: 94150 'separate procedure' doesn't every time mean separate coding.

New codes aren't just the only things that affect your coding in 2012 -- you also need to cull through the most recent Correct Coding Initiative (CCI) edits to make certain you appropriately report multiple procedures. CCI edits 2012 went into effect Jan. 1, 2012, with substantial changes to how you should code familiar injection or incision/drainage procedures.

Report Injection Over Compression, Aspiration

CCI edits 2012 includes 15,530 new edit pairs. In case your physician manages trigger point, joint, or tendon injections, don't miss the CCI edits involving those procedures:

Trigger point injection codes 20552 and 20553 are the Column 1 codes with novel codes 29582 (Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed) and 29584 (… upper arm, forearm, hand, and fingers).

Joint injection codes 20600, 20605, and 20610 are the Column 1 codes with novel procedures 20527 (Injection, enzyme [e.g., collagenase], palmar fascial cord [i.e., Dupuytren's contracture]), 29582, 29583 (Application of multi-layer compression system; upper arm and forearm), and 29584.

Tendon injection procedures 20526 and 20527 are selected as the Column 1 code for more than 130 edit pairs. The coupled procedures range from abscess aspirations and therapeutic injections to cast applications, venipuncture, and anesthetic injections, to name a few. Search through the CCI edits to see which ones might apply to your providers.

Reminder: When CCI edits pair two codes together, you'll normally report the Column 1 code in place of the Column 2 code. The Column 1 code either signifies a procedure that involves the services of the Column 2 code, or denotes a procedure that "outweighs" the Column 2 code and should be reported alone.

I&D or Debridement Override Compression

A number of other CCI edits are also applicable to novel code 29582 (Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed). The compression system application is part of the service represented by incision/drainage or debridement codes for instance:

10060 – (Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single)

10061 – (… complicated or multiple)

10140 – (Incision and drainage of hematoma, seroma or fluid collection)

10160 – (Puncture aspiration of abscess, hematoma, bulla, or cyst)

11000 – (Debridement of extensive eczematous or infected skin; up to 10% of body surface.)

The CCI edits 2012 keep your medical coding consistent with CPT guidelines. Each edit pair carries a modifier indicator of "1," however, which implies that you might occasionally be able to sidestep the edit with a modifier and be paid for both services (such as modifier 59, Distinct procedural service).

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