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Watch out for dissimilar sessions or sites before you attempt to break these bundles. In case your podiatrist is carrying out venous compressions, you might already know about novel procedure CPT code 29582 (Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed), presented in CPT® 2012. And now you are required to know how that code is affected by the latest round of Correct Coding Initiative (CCI) edits, effective January 1, 2012. According to CCI 18.0, CPT code 29582 is bundled into all "Fracture and/or Dislocation Procedures on the Foot and Toes" codes (28400-28675). It is also considered an essential part of these codes: 28001 – (Incision and drainage, bursa, foot) 28002 – (Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space) 28124 – (Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (e.g., osteomyelitis or bossing); phalanx of toe) 28234 – (Tenotomy, open, extensor, foot or toe, each tendon) 28238 – (Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (e.g., Kidner type procedure) 28240 – (Tenotomy, lengthening, or release, abductor hallucis muscle) 28250 – (Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure)) 28285 – (Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)) 28292 – (Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure) 28310 – (Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)) CPT code 29581 (Application of multi-layer compression system; leg [below knee], including ankle and foot) is also bundled into these similar CPT codes. CPT® revised the code description for 2012 to identify that the procedure includes the ankle and foot. The venous compressions are performed for varicose veins, postphlebitis syndrome, atherosclerosis, chromic venous hypertension, or stasis ulcers in the limb(s). Unbundling opportunity: These bundles are all marked with modifier indicator "1," which may permit you to break the bundle. In few clinical circumstances you can override -- not ignore -- CCI edits and receive separate payment for bundled codes. To find out if you can separately bill services, first check the "modifier indicator" in column F of the CCI spreadsheet. Remember: All edits consist of code pairs that are arranged in two columns (Column 1 and Column 2). CPT codes that are listed in Column 2 are not payable if carried out on the similar day on the same patient by the same provider as the code listed in Column 1, lest the edits allow the use of a modifier associated with CCI Edit . A "0" indicator implies that you cannot unbundle the two CPT codes under any condition. An indicator of "1," though, implies that you may use a modifier to override the edit if the clinical conditions warrant distinct payment.
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