decisionhealth Newsletters, Part B News - 2017 Issue 6 (June)
E/M codes, prolonged care are the target of latest CCI bundled-code update
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Article Overview
This article reviews recent CMS Correct Coding Initiative and MUE changes that affect multiple specialties and service types, including evaluation and management, prolonged services, moderate sedation, injections, pain procedures, therapy evaluations, and related same-day billing edits. It is intended for coders, billers, and reimbursement staff who need a high-level view of what changed in the July 1 update and which broad code families are affected.
Why This Topic Matters
The update affects claim editing and same-day reporting across a wide range of common services, so readers need to know which code families were added, deleted, or revised and where modifier-related edits may apply.
Article Sections
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CCI version 23.2 update overview
Introduces the scope of the July 1 billing edits and the main service categories affected by the update.
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E/M and cognitive-assessment edits
Summarizes edits involving dementia assessment and evaluation and management code families, including same-day reporting topics and modifier-related considerations.
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Plotting prolonged services
Covers edits involving non-face-to-face prolonged service reporting and related code families across several specialties.
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Extra hours added for clinical staff
Describes the MUE update affecting prolonged clinical staff time and the general implications of the revised unit limits.
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Deleted edits impact office, ASC pain procedures
Reviews deleted pair edits affecting sacroiliac joint injections, pain procedures, and ambulatory surgical center reporting.
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CCI, MUE version 23.2 scorecard
Provides a summary table of the number of edits added, deleted, and revised across broad code ranges.
What You Will Learn
- Which broad service categories were affected by the latest CCI and MUE changes
- How the update impacts same-day reporting topics across E/M, prolonged services, injections, and therapy evaluations
- Which general code families were added or deleted in the July 1 edit cycle
- What the article says about the scope of the MUE revision for prolonged clinical staff service
- How the scorecard summarizes changes across broad code ranges
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Revenue cycle professionals
- Specialty practice administrators
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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