Urology coding: Stay on top of CCI 16 edits

Published: 23rd February 2010
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These days, a urology coder's hands are already full trying to walk through the maze of all 2010 CPT changes. To make things worse for her, the latest CCI (correct coding initiative) edits version 16.0 ties her hands on some code pairings, including the new 2010 urodynamics codes. These CCI edits introduces 24,060 new active pairs and 869 modifier changes.

The current CCI bundles new 2010 CPT code 53855 into 52282. Medicare bases the edit on the logic that 53855 and 52282 are mutually exclusive. This means payers who follow CCI will not reimburse the urologist for insertion of both a permanent stent and a temporary stent at the same time. The bundle has a modifier indicator of "1", which means one can bypass the CCI edit with a modifier such as modifier 59, under proper circumstances.

Also, according to CCI, one should forget billing a basic catheterization along with the new 2010 urodynamic codes. So the ruling is that it's not possible to report 51701 with effect from last month.

It's very important that an urology coder stays current on urology coding information such as these. But the hitch for many full-time urology coders is that their coding schedule leaves them with little or no time to go through thick coding books or for that matter devote two-three days at a stretch for attending urology coding conferences or seminars.

But help is certainly close at hand for busy urology coders; there are audio recordings in both CDs and MP3s to help them lap up the latest information and stay on target, that too from just about anywhere!

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