CPT 2011 / Hot Coding Topics

Make Sure To Check CCI Before You Use The New 2011 Codes

Capture additional pay by separating wound care management codes 97597-97602 from the newly revised debridement codes.

Every year, just when you’re trying to get used to new CPT codes, the Correct Coding Initiative (CCI) comes along and limits how and when you can use the new codes you’ve been given. This year is no exception with CCI 17.0 adding edits involving new Renessa and posterior tibial neurostimulator (PTNS) codes, among others.

The CCI released version 17.0, revealing 19,822 new active pairs and 9,778 code pair deletions, said Frank D. Cohen, MPA, MBB, senior analyst with The Frank Cohen Group, LLC, in a Dec. 14 announcement.

Many of the new code pair additions involve CPT codes that debuted on Jan. 1, 2011 with CCI getting ready to halt payment if you report certain procedures together. Get a grip on the new bundles with this urology-focused rundown.

CPT 2011 deleted Category III code 0193T (Transurethral, radiofrequency microremodeling of the female bladder neck and proximal urethra for stress urinary incontinence), replacing it with a new Category I code 53860 with the same descriptor. CCI targets 53860 with several edits.

When your urologist performs the Renessa procedure, you’ll report 53860, says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York at Stony Brook.

As of Jan. 1, when 53860 became an active code, CCI 17.0 created edit pairs with the following column 2 codes that Medicare considers usual and necessary parts of any surgery:

  • Venipuncture, IV, infusion, or arterial puncture services represented by codes 36000, 36400- 36440, 36600-36640, and 37202
  • Naso- or oro-gastric tube placement (43752)
  • Bladder catheterization (51701-51703).

“In general CPT code 53680 would include catheter placement for temporary postoperative urinary drainage at the conclusion of the procedure, and therefore, these latter...

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January 31, 2011
CCI / Hot Coding Topics

Ob-gyn Coding: Clue In To These CCI Edits Before You Choose 0193T

Overlooking these new Interstim and hemorrhoid destruction bundles could mean denial headaches.

Don’t let CCI version 16.1’s lack of ob-gyn mutually exclusive edits lull you into a false sense of security. Here’s what you need to know to prevent a denial from landing on your desk.

Payers like Noridian Part B will cover the female stress urinary incontinence treatment code 0193T, but before you submit a 0193T claim, you’ll have to check with the Correct Coding Iniative (CCI) version 16.1’s edits. For instance, as of April 1, the work represented by 0193T will include that of cystourethroscopy codes 52000-52001 and 52281.

1. Look For 0193T in Both the Column 1, Column 2 Position

In 2009, CPT added 0193T (Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence) to your possible stress urinary incontinence (SUI) treatment coding options. This code includes the Renessa transurethral collagen radiofrequency denaturation procedure. Ob-gyns typically perform this nonsurgical, minimally invasive alternative for women who have failed other nonsurgical treatments or who aren’t good candidates for surgery.

What happens: The ob-gyn uses controlled heat at low temperatures and targets tissue in the woman’s lower urinary tract. The heat changes the structure of the patient’s natural tissue collagen. This helps the firmness of tissue and improves her continence. Although the ob-gyn may use heat on multiple sites and document multiple cycles, you should report 0193T once to represent all the treatment cycles performed during an encounter.

As of April 1, 0193T will include the work represented by 52000-52001 (Cystourethroscopy …) and 52281 (Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female).

Reaction: “These edits don’t surprise me at all because 0193T says ‘transurethral’ which implies the...

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June 7, 2010
CCI / CPT / Hot Coding Topics / modifier 59 / NCCI

CCI 16.1: Seize the Opportunity to Report 0193T — But Don’t Get Tripped Up By These Edits

Overlooking these new Interstim and hemorrhoid destruction bundles could mean denial headaches.

Payers like Noridian Part B will cover the female stress urinary incontinence treatment code 0193T, but before you submit a 0193T claim, you’ll have to check with the...

Comments Off on CCI 16.1: Seize the Opportunity to Report 0193T — But Don’t Get Tripped Up By These Edits
April 14, 2010