CMS and the NCCI has removed the current edit prohibiting the reporting of CPT codes 77295 and 77300 together, effective July 1, 2016. The change will be finalized in the July version of the NCCI Manual and will be retroactive to January 1, 2016. Reporting requirements may vary by payer:
Claims reported to Medicare contractors:
Claims for CPT codes 77295 and 77300 should not be reported together until the edit is removed on July 1, 2016. Practice billing systems can begin capturing charges for 77300; however, the charges should not be released to Medicare until July 1, 2016. All prospective and retrospective pending charges for 77300 may be released on or after July 1, 2016.
Claims reported to private payers:
Depending on state guidelines and individual payer policies, some private payers may not permit claims to be submitted after a certain period of time has passed. Therefore, practices could consider submitting charges for 77300 to commercial payers prior to July 1, 2016. Refer to your payer’s individual reporting policies for guidance on when to submit claims for 77295 and 77300.
Click here to read the original article on the prohibition of reporting 77295 and 77300 together.
The Medical Management Institute – MMI – Medical Coding News & MMI Updates