CMS to Repeal Three NCCI Arthrography Edits
The National Correct Coding Initiative (NCCI), version 16.1, to be released April 1, 2010, will delete the following three active arthrography NCCI Medicare edits:
· 27093 / 77002 (injection procedure for hip arthrography; without
anesthesia / fluoroscopic guidance for needle placement
(eg, biopsy, aspiration, injection, localization device))
· 27095 / 77002 (injection procedure for hip arthrography; with
anesthesia / fluoroscopic guidance for needle placement
(eg, biopsy, aspiration, injection, localization device))
· 27370 / 77002 (injection procedure for knee arthrography/
fluoroscopic guidance for needle placement (eg, biopsy, aspiration,
injection, localization device))
Deletion of these edits is a result of the joint efforts of the American College of Radiology (ACR) and the American Society of Neuroradiology (ASNR). The ACR and ASNR argued that fluoroscopy is inclusive to the 70000 series arthrography codes, not the surgical codes. When only a CT or MRI arthrography procedure is performed, it is appropriate to report the injection procedure code (21116, 23350, 24220, 25246, 27093, 27095, 27096, 27370, or 27648), the code for fluoroscopic guidance (77002), and the 70000 series CT or MRI arthrography imaging code (73201, 73202, 73222, or 73223). As noted in the January 2002 ACR Bulletin article titled, Coding for Shoulder and Other Arthrographic Procedures, fluoroscopy used for intra-articular injection for enhanced CT and enhanced MR arthrograph involves more physician work and a higher degree of complexity than the intravenous injection of contrast included with other CT or MR "with contrast" procedures. Therefore, fluoroscopy should be reported separately in these instances.
