National Correct Coding Initiative: Know These New PTP Edit Pairs

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

Article Overview

This article explains a 2019 National Correct Coding Initiative update and highlights selected procedure-to-procedure edit changes involving new CPT code groups across biopsy, evaluation and management, chronic care management, sedation, and psychological testing-related services. It is aimed at coders, compliance staff, and reimbursement professionals who need to understand the scope of the edit changes and the general types of code pairings affected.

Why This Topic Matters

PTP edits can affect whether paired services are separately reportable and reimbursed, so awareness of the update helps coding and compliance teams review claims more accurately and reduce avoidable denials.

Article Sections

  1. New Biopsy Codes Bring New Edits

    Summarizes how the update affects newly added biopsy-related codes and their relationship to other integumentary surgery and sedation services.

  2. Especially With E/M Services

    Reviews the impact of the edits on evaluation and management services, including new patient, established patient, consultation, and telephone or electronic consultation categories.

  3. Take Care with New Chronic Care Management Code …

    Covers the edit changes involving chronic care management and related non-face-to-face, care planning, and transitional care service categories.

  4. and Don’t Let the New Psych Codes Psych You Out

    Addresses the new psychological and neuropsychological testing service codes and their interactions with adaptive behavior assessment and treatment services.

What You Will Learn

  • What the 2019 NCCI update broadly changed
  • Which major service categories were affected by the edit review
  • How the article frames the impact on biopsies, E/M services, chronic care management, and psych testing
  • Where to look for the full list of current PTP edits

Who Should Read This

  • Medical coders
  • Compliance analysts
  • Physician billing staff
  • Reimbursement professionals
  • Practice managers

Codes Discussed

  • CPT: 11102
  • CPT: +11103
  • CPT: 11104
  • CPT: +11105
  • CPT: 11106
  • CPT: +11107
  • CPT: 99156
  • CPT: 99201
  • CPT: 99205
  • CPT: 99211
  • CPT: 99215
  • CPT: 99241
  • CPT: 99245
  • CPT: 99446
  • CPT: 99451
  • CPT: 99491
  • CPT: 98960
  • CPT: 98962
  • CPT: 98966
  • CPT: 98969
  • CPT: 99358
  • CPT: +99359
  • CPT: 99366
  • CPT: 99368
  • CPT: 99374
  • CPT: 99380
  • CPT: 99441
  • CPT: 99444
  • CPT: 99487
  • CPT: 99495
  • CPT: 99496
  • CPT: 96130
  • CPT: 96146
  • CPT: 97151
  • CPT: 97152
  • CPT: 97153
  • CPT: 97158

Code Ranges Discussed

  • CPT: +10004-10021
  • CPT: 11004-11006
  • CPT: 11010-11012
  • CPT: 11043-+11047
  • CPT: 99201-99205
  • CPT: 99211-99215
  • CPT: 99241-99245
  • CPT: 99446-99451
  • CPT: 98960-98962
  • CPT: 98966-98969
  • CPT: 99366-99368
  • CPT: 99374-99380
  • CPT: 99441-99444
  • CPT: 99487-99491
  • CPT: 99495-99496
  • CPT: 96130-96146
  • CPT: 97153-97158

Modifiers Discussed

  • CPT: 25

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