National Correct Coding Initiative (NCCI) Changes On July 1, 2016

We’ve just entered a new calendar quarter, so the NCCI edits are revised.

There are numerous changes, which we’ve posted for members under the 'Newsletters' section. Here are some examples:

Procedure-to-Procedure Edits

New Edits

Column 1 Code

Description

Column 2 Code(s)

Description

Modifier Indicator

0254T

Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using bifurcated endoprosthesis from the common iliac artery into both the external and internal iliac artery, unilateral;

37222

Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

1

34802

Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using modular bifurcated prosthesis (1 docking limb)

37222

Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

1

35306

Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition to code for primary procedure)

35500

Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to code for primary procedure)

1

36475

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated

36479

Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)

0

37184

Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel

61651

Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (List separately in addition to code for primary procedure)

1

47533

Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external

47544

Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

1

61645

Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)

61650

Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory

1

76604

Ultrasound, chest (includes mediastinum), real time with image documentation

76942

Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation

1

76641

Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete

76942

Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation

1

76830

Ultrasound, transvaginal

76942

Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation

1

76998

Ultrasonic guidance, intraoperative

47379

Unlisted laparoscopic procedure, liver

1

99145

Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; each additional 15 minutes intra-service time (List separately in addition to code for primary service)

94761

Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)

0

 

Deleted Edits

Column 1 Code

Description

Column 2 Code

Description

43761

Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition

76000

Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time, other than 71023 or 71034 (eg, cardiac fluoroscopy)

50080

Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm

76000

Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time, other than 71023 or 71034 (eg, cardiac fluoroscopy)

50200

Renal biopsy; percutaneous, by trocar or needle

76942

Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation

50390

Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous

77002

Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device)

62284

Injection procedure for myelography and/or computed tomography, lumbar

77003

Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid)


Revised Edits

Column 1 Code

Description

Column 2 Code

Description

New Modifier Indicator

Old Modifier Indicator

72082

Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views

72081

Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view

1

0

72083

Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views

72081

Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view

1

0

 

Medically Unlikely Edits

New Edits

HCPCS/ CPT Code

Description

Outpatient Hospital Services MUE Values

C2623

Catheter, transluminal angioplasty, drug-coated, non-laser

3

 

Deleted Edits

No deleted MUEs on July 1, 2017.

Revised Edits

HCPCS/ CPT Code

Description

Outpatient Hospital Services MUE Values

Old MUE

92920

Percutaneous transluminal coronary angioplasty; single major coronary artery or branch

3

1

92937

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

2

3

93005

Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report

5

3

C9602

Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch

2

3

C9606

Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel

1

2


Add-On Code Edits

New Edits

Add-on Code

Description

Primary Codes

0439T

Myocardial contrast perfusion echocardiography; at rest or with stress, for assessment of myocardial ischemia or viability (List separately in addition to code for primary procedure)

93306, 93307, 93308, 93350, 93351