tci Medicare Compliance & Reimbursement - 2007 Issue 36

CCI EDITS: Avoid Spinal Surgery Denials By Heading CCI Changes

No modifier will overcome 13.3's hundreds of new surgery editsBad news: You can pretty much give up on billing some rectum and anus surgery codes with a number of other surgery codes, under any circumstances. The Correct Coding Initiative version 13.3 creates a number of bundles involving:• rectum manipulation codes 45900-45915;• 46040 (I&D of ischiorectal and/or perirectal submuscosal abscess, transanal, under anesthesia) and 46080 (Sphincterectomy, anal, division of sphincter); and• anal excision codes 46200-46220.CCI gives these edits a modifier indicator of "0," so you cannot use a modifier to override...

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