decisionhealth Newsletters, Part B News - 2017 Issue 3 (March)
Injections get bundled, prolonged services limited in CCI update
Subscribe or sign in to view the full article.
Article Overview
This article summarizes a CMS Correct Coding Initiative quarterly update and highlights how it affects multiple areas of medical coding, including injection-related edits, non-face-to-face prolonged services, cerumen removal, chronic care management, transitional care management, health risk assessments, and selected hospital service pairings. It is relevant to coders, billers, compliance staff, and practices that need to track CCI changes, modifier restrictions, and deleted code pairs effective in the April 1 update.
Why This Topic Matters
The update changes how several commonly billed services interact under CCI, including newly added and removed edit pairs and limits tied to billing frequency or time-based services. Understanding the scope helps practices avoid denials and stay aligned with current CMS guidance.
Article Sections
-
CCI edits
Introduces the quarterly CCI update and summarizes the main categories of code-pair changes included in the release.
-
Prolonged services capped at 2 hours
Covers the update affecting non-face-to-face prolonged services and the associated billing-time limitation discussed in the article.
-
Cerumen removal limited to 1 service
Describes the revised treatment of cerumen-removal coding and the impact on same-day reporting.
-
CCM-initiating code G0506 gets restricted
Summarizes the edit changes involving the chronic care management initiating visit code and related prolonged service pairings.
-
TCM, HRAs see eased access
Reviews deleted edit pairs affecting transitional care management, health risk assessments, and selected hospital and screening services.
-
CCI Version 23.1 scorecard
Presents the article’s summary table of code-range activity for the quarterly CCI release.
What You Will Learn
- What types of services were affected by the quarterly CCI update
- How the article groups added and deleted code-pair edits
- Which broad service categories were discussed in relation to modifier restrictions
- How the update affects several commonly billed outpatient and facility-related services
- What the article emphasizes about tracking effective dates for CCI changes
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Revenue cycle professionals
- Physician practice administrators
- Healthcare providers who bill CMS-related services
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com