NCCI policy manual targets biopsy codes, lesion repair, bilateral services

December 18th, 2018

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains selected updates in the revised Medicare NCCI Policy Manual for 2019. It is aimed at coders, billers, and compliance staff who need to understand how the manual addresses biopsy reporting, wound repair versus tissue transfer, bilateral procedures, laboratory test reporting, and a therapy-related code edit. The piece focuses on broad policy changes and the general types of coding guidance included in the manual.

Why This Topic Matters

The revised NCCI Policy Manual can affect whether claims are correctly reported and whether services are bundled or separately billable under Medicare policy. Understanding the update topics helps practices review coding workflows, reduce claim edits, and prepare for annual code set changes.

Article Sections

  1. Wrap in new biopsy codes

    Covers the section of the manual addressing updated biopsy reporting guidance and related code-set changes for skin lesion procedures.

  2. Focus on your repairs

    Discusses manual guidance for wound closure, repair coding, and tissue transfer or rearrangement concepts in the context of revised policy language.

  3. Navigate bilateral services

    Summarizes the manual’s reinforcement of reporting rules for bilateral procedures and related modifier use.

  4. Limit your lab coding

    Describes guidance on laboratory reporting limits and a related immunology subsection added to the manual.

  5. Cognitive skills code bundled

    Addresses the manual’s bundling guidance for a therapy-related HCPCS code and selected speech/language therapy services.

What You Will Learn

  • How the revised NCCI Policy Manual addresses selected biopsy, repair, bilateral, laboratory, and therapy coding topics
  • Which areas of Medicare coding guidance were clarified or reinforced for 2019
  • How the article frames the impact of manual updates on billing review and compliance workflows
  • What broad categories of services are affected by the policy changes discussed in the article

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance personnel
  • Practice managers
  • Healthcare reimbursement professionals

Codes Discussed

  • CPT: 11102
  • CPT: 11103
  • CPT: 11104
  • CPT: 11105
  • CPT: 11106
  • CPT: 11107
  • CPT: 11100
  • CPT: 11101
  • CPT: 27395
  • CPT: 69210
  • CPT: 86003
  • CPT: 86008
  • CPT: 92507
  • CPT: 92508
  • CPT: 97532
  • CPT: 12001
  • CPT: 13160
  • CPT: 14000
  • CPT: 14001
  • CPT: 14020
  • CPT: 14021
  • CPT: 14040
  • CPT: 14041
  • CPT: 14060
  • CPT: 14061
  • CPT: 14301
  • CPT: 14302
  • CPT: 14350
  • HCPCS Level II: G0515

Code Ranges Discussed

  • CPT: 11102-11107
  • CPT: 12001-13160
  • CPT: 14000-14350

Modifiers Discussed

  • CPT: -50

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