tci Outpatient Facility Coding Alert - 2020 Issue Q1

Reader Question: Dive Deep Into This NCCI Edit Rule

Question: We’ve begun receiving denials when reporting 36478 with 36471. I found the Centers for Medicare & Medicaid Services (CMS) introduced a new National Correct Coding Initiative (NCCI) edit that bundles these codes with a modifier “1” indicator. Can I still report them separately? Indiana Subscriber Answer: You are correct that as of October 1, 2019, a new NCCI procedure-to-procedure (PTP) edit exists between codes 36478 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated) and 36471 (Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same...

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