Get 2016 CCI News for Angiography Reporting

By Susan Dooley

Got CCI edits on your mind? Coders should be thinking about the National Correct Coding Initiative
(NCCI or CCI) quarterly updates, since weve already had two quarterly updates so far, in January and
April, with two more edit versions going into effect on July 1 and October 1. As you know, CCI edits
consist of pairs of CPT or HCPCS level II codes that cant be paid separately except in certain
circumstances. Edits are applied to services billed by the same provider for the same patient on the
same date of service. Incorrect reporting of codes that are part of a CCI edit pair can lead to claim
denials and rejections.
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

And of course the updated 2016 Correct Coding Initiative manual went into effect on January 1, also,
with a number of changes affecting cardiology coding. We talked about the edit affecting abbreviated
right heart catheterization with biopsy a while back. Now, lets look at the manuals changes regarding
angiography.

Reporting Angiography With Intervention

Grab your 2016 CCI manual (you can download a zipped copy here at the CMS website) and pull out
Chapter V, which covers surgery, specifically that of the respiratory, cardiovascular, hemic, and
lymphatic systems. As you know, CPT codes 30000 through 39999 include procedures performed on
these systems.

Find page V-13 and scan down the page for #12, which addresses open and percutaneous interventional
vascular procedures like operative angiograms and venograms. According to the manual, operative
angiograms and/or venograms shouldnt be reported separately as diagnostic angiograms or venograms.
However, the CPT Manual gives some circumstances where a provider could separately report a
diagnostic angiogram or venogram at the same time as an interventional vascular procedure. Regarding
that, check out how the CCI Manual language has changed this year.
2015: Last years manual said A separately reportable diagnostic angiogram/venogram may be
reported with modifier 59 when performed at the time of an interventional procedure.
2016: This years manual clarifies that statement, adding new language (in red text here) that
acknowledges CPT manual guidelines: A diagnostic angiogram/venogram may be separately
reportable with modifier 59 if it satisfies CPT Manual guidelines, national Medicare guidelines, and local
Medicare Administrative Contractor guidelines.

Whats the Bottom Line?

If your practice serves Medicare patients, youve probably already been considering and following CPT
guidelines, local Medicare Administrative Contractor (MAC) rules, and national Medicare rules as you
determine the correct way to code a case. The great thing about a change like this? The more specific
language in the 2016 CCI manual confirms this approach, telling you that you were doing it right.

Got CCI Tips?

With CCI edit changes coming out every quarter, you have a lot to keep up with. Do you have any tips to
share on ways you stay current? Let us know.

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

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Contact Us:
Name: Sam Nair
Title: Associate Director Enterprise Practice
Email: shyamn@codinginstitute.com
Direct: 704 303 8150

Desk: 866 228 9252, Ext: 4813

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com