Academy maintains clinically appropriate coding edits

October 2017 - Vol. 36, No. 09

The National Correct Coding Initiative (NCCI), a division of the Centers for Medicare and Medicaid Services (CMS), periodically reaches out to the Academy to request feedback on proposed changes to various Current Procedure Terminology (CPT) codes. When implemented, these modifications, called procedure to procedure (PTP) edits, can directly impact physician reporting and billing for certain procedures (for example, what services can be reported together on the same date of service).

In response to proposed PTP edits for CPT codes describing laryngectomies paired with cervical lymphadenectomies, the Academy’s CPT team  submitted written comments advocating against coding edits. This would disallow these procedures to be performed on the same patient on the same day.

Following the Academy’s advocacy effort, NCCI agreed with the Academy’s rationale and decided against the implementation of the proposed  modifications on October 1, 2017. In response, the Academy thanked NCCI for taking the CPT team’s concerns into consideration when making the final determination.