| by Cheryl Nash |
| Some of you may have seen the new NCCI edit that became effective on 10/01/2019 for CPT codes 36478 and 36470/36471. For those that haven’t, the edit has listed codes 36470/36471 as column 2 codes to 36478. In brief, that means they are considering sclero as inclusive to a laser ablation in some circumstances.
The edit has an indicator of “1” which allows for billing with a modifier such as 59 or XS in order to bypass the edit when appropriate. An example for billing separately would be if the two procedures are performed at separate anatomic sites or at separate patient encounters on the same date of service.
Of note is that the edit was not applied to other ablative procedures such as 36475, 36465 or 36482. |
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