2 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 0
O
ne of your
top priorities
as a surgical
administrator is to
maximize reimburse-
ments for the services
performed at your
facility. That's no small
task when dealing
with complex, bun-
dled payment arrange-
ments — a group of
procedures covered
by a single, compre-
hensive CPT code.
There are two meth-
ods to use when cod-
ing bundled proce-
dures:
• National Correct
Coding Initiative
(NCCI) edit bundling.
This is CMS's strict set of bundling guidance, which lets providers
know which CPT codes may be bundled when their procedures are
performed in the same outpatient surgical setting. On top of federal
payers, many commercial payers have adopted this bundling guidance
because it's easy to apply and clearly spelled out.
Don't Leave Money on the Table
The bundling guidance you follow impacts your reimbursement rates.
Coding & Billing
Bob Lathrop, CPC, CPC-I, CASCC
• SEPARATE CHARGES Coding according to the American Medical Association guide-
lines could let you earn more for performing two shoulder procedures at one time.
