CCI Edits: Navigate Surgery Bundles That Could Compromise Your Pay

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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 how recent Correct Coding Initiative updates affect billing for several new CPT code families, including fine needle aspiration, skin biopsy, peripherally inserted central venous catheter placement, and interprofessional consultation/referral services. It is aimed at coders and billers who need to understand the scope of bundled edits, the significance of modifier indicators, and the general categories of services impacted by the new CCI release.

Why This Topic Matters

It helps coding professionals identify where new CCI edit pairs may affect claim reporting for 2019 CPT services and highlights which service categories require close review under the latest bundling updates.

Article Sections

  1. Focus on These FNA Edits

    Reviews CCI edits associated with new fine needle aspiration code families and discusses how modifier indicators affect bundled pairs. The section also references related service categories that appear in the edit sets.

  2. Ponder New Skin Biopsy Edits

    Summarizes edit activity surrounding new skin biopsy codes and notes additional service categories involved in the corresponding edit pairs. The section focuses on the overall impact of the CCI updates on these biopsy-related services.

  3. Limit New PICC Code

    Covers edit pairs involving the new peripherally inserted central venous catheter codes and the broader categories of services linked to them. It also identifies situations where the edits are grouped with other vascular access and related services.

  4. Skim Through Edits With 99451 and 99452

    Discusses CCI edits involving new interprofessional consultation and referral codes and their placement in bundled pairs. The section emphasizes the general role of these codes in the updated edit sets.

What You Will Learn

  • The main service categories affected by the new CCI edit updates
  • How modifier indicators are used in the context of bundled edit pairs
  • Which broad code families are highlighted in the article
  • How the article frames review of newly added CCI edits for 2019

Who Should Read This

  • Medical coders
  • Medical billers
  • Practice administrators
  • Revenue cycle staff
  • Compliance teams

Codes Discussed

Code Ranges Discussed

Modifiers Discussed


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