June 03, 2015
NCCI Deletes Arterial Line/TAP Block Edits
In response to concerns raised by the American Society of Anesthesiologists (ASA), the Centers for Medicare and Medicaid Services (CMS) has deleted National Correct Coding Initiative (NCCI) edits that paired the placement of an arterial line (CPT Code 36620) with transversus abdominis plane (TAP) blocks (CPT Codes 64486 through 64489). ASA formally requested this action in a March 2015 letter to Correct Coding Solutions, LLC – the contractor CMS uses to administer the NCCI program.
Previously, the NCCI included edits that paired the placement of an arterial line (CPT Code 36620) with transversus abdominis plane (TAP) blocks (CPT Codes 64486 through 64489). When these services were reported together, the claim for the TAP block was denied. ASA is pleased to see that CMS recently posted Version 21.2 of the NCCI which reflected the request for deletion. Physician anesthesiologists should take note that claims denied due to these edits may be re-submitted after July 1, 2015 when version 21.2 takes effect.
Unfortunately, NCCI edits pairing anesthesia services with transesophageal echocardiography (TEE) as described by CPT Code 93355 have not been revised - - Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg,TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal defect closure) (peri-and intra-procedural), real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report, including diagnostic transesophageal echocardiography and, when performed, administration of ultrasound contrast, Doppler, color flow, and 3D.
ASA will continue to encourage CMS to revise these edits to allow for separate reporting of code 93355 when performed by the physician anesthesiologist providing anesthesia care for the underlying surgical procedure.
As more information is made available, ASA will provide updates. Please contact ASA’s Director of Payment and Practice Management, Sharon Merrick, at firstname.lastname@example.org with any questions.