decisionhealth Newsletters, Part B News - 2018 Issue 12 (December)
Coming CCI edits bundle E/M services, reduce allowable lesion-removal units
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Article Overview
This article explains a new Correct Coding Initiative update affecting a wide range of CPT services as it takes effect at the start of the year. It is aimed at coding professionals who need to understand broad patterns in claim bundling, modifier indicators, and medically unlikely edit changes across multiple specialties and service categories. The discussion focuses on how the update touches office E/M, skin procedures, interprofessional consults, psychological testing, chronic care management, and related imaging or procedural services.
Why This Topic Matters
The update changes how many common services may be reported together and how many units may be allowed for certain procedures. Coders, billers, and compliance staff need to know which service families are affected so they can review claims workflows and avoid denials or restricted billing.
Article Sections
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CCI edits
Overview of the annual Correct Coding Initiative update and the broad service families affected by the new bundling and restriction patterns.
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Debridement services bundled
Discussion of bundling patterns involving debridement services and biopsy services, including the role of modifier indicators.
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Biopsy codes part of sizable bundles
Coverage of how the newer biopsy service codes are tied to many edit pairs and how those edits are organized in the update.
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Reduced caps for lesion removals
Explanation of medically unlikely edit changes affecting units of service for several integumentary procedures and related reporting concerns.
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Interprofessional consult codes tied up
Summary of edit relationships involving interprofessional consult services, office visits, and select imaging-related services.
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E/M pairs with psychological testing
Discussion of edit relationships between office E/M services, chronic care management, psychological testing, and prolonged service categories.
What You Will Learn
- How a Correct Coding Initiative update can affect bundling across multiple CPT service families
- Which broad categories of services are affected by new modifier indicators and unit limits
- How the article frames changes involving office E/M, skin procedures, consults, and testing services
- Why medically unlikely edit changes matter for claims reporting and workflow review
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Practice managers
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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