Cardiology Edit Pairs: Know what's in and What's Out

CCI 16.2 went in full effect on July 1 this year. If youoverride the edit with a modifier like 59 when
are a cardiology coder, you need to beware of codingappropriate. Now CCI also bundles 93000-93010 into
transcatheter therapy and vascular imaging on thecardiac CT codes 75571-75574. These edits also
same date. However there is good news too.have a modifier indicator of 1.
What's been deleted: Correct coding initiatives deletesRemember: As modifier 59 has the potential to bypass
edits for MTWA and stress testsCCI edits, practices use this modifier quite often.
Earlier, you faced an edit that has barred reportingHowever you should never use modifier 59 just to get
cardiovascular stress test codes 93015-93017 withpaid for a procedure.
93025. But from July 1, you are able to report theseThat apart, CPT instructions say that if a more specific
codes together, owing to an edit deletion in the newmodifier describes the situation, you should go for
CCI edits.modifier 59. This modifier should be a modifier of last
What's in: Comply with new ECG and Imaging Editsresort and only used when there's no other modifier to
Of all the just-in correct coding initiatives, ensure youcompliantly bypass the bundling edit, and the procedure
note these areas in particular: Now CCI bundles 75896was clearly distinct and different from that of the other
into many codes, including endovascular repair codesprocedure. For instance modifiers LT and RT may be
34800-34805, as well as vascular procedure codesmore apt for your case.
75600-75791 and 75810-75891. These edits have aFor more on the CCI 16.2 edits, sign up for a one-stop
modifier indicator of 1, which means that you mayMedical Coding Website.