The Heart Rhythm Society succeeded once again in its objection to proposed National Correct Coding Initiative (NCCI) edits — scheduled to take effect on April 1, 2009 (Version 15.1) — that would have discontinued modifier usage for billing of an insertion or replacement of a pacemaker or ICD pulse generator (33212-33214, 33240 and 33249) performed on the same day as a device interrogation and/or programming service (93279-93284 and 93288-93289).

On January 1, 2009, NCCI implemented edits that bundled these services when reported together on the same date of service based on CPT manual instructions. However, under normal circumstances, these services would not be reported separately. The edits currently in place allow modifiers to be used to bypass claim system edits when there are situations where these procedures are performed at separate patient encounters on the same date of service.

In an appeal letter dated December 19, 2008, the Heart Rhythm Society, supported by the American College of Cardiology, expressed concern about the CMS proposal to modify the edits on April 1 to no longer allow use of NCCI-associated modifiers. Read the Society's appeal letter (PDF, 140K).

CMS agreed with the Society “that there are appropriate circumstances where the two codes of a code pair edit may be reported separately for services performed at separate patient encounters on the same date of service.” Thus, CMS will continue to allow use of NCCI-associated modifiers with these services. Read the response from CMS (PDF, 116K)