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NCCI Bundling Edit Delayed

The NCCI bundle of 92012, intermediate eye exam, and 92014, comprehensive eye exam, with intravitreal injections, 67028, planned for July 1, 2014, has been delayed.  CMS plans to postpone this edit while it looks at other issues associated with the injection code 67028. 

CMS will proceed with edits bundling visit codes with other minor and major procedures requiring the addition of modifiers 25 or 57 to appropriately documented visits for reimbursement purposes.  This edit was originally implemented in July, 2013, and was suspended in October, 2013, due to Medicare contractors’ inability to process these claims accurately. 

At this time, no further details exist on what “other issues” CMS will investigate regarding CPT code 67028. 

For more information on the proper use of modifiers 25 and 57, see our FAQs on our website at https://www.corcoranccg.com/products/faqs/.

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