2021 NCCI Updates: What PTs, OTs, and SLPs Need to Know
https://www.webpt.com/blog/2021-ncci-updates-what-pts-ots-and-slps-need-to-know/
Check out the January 2021 NCCI edits for PTs, OTs, and SLPs. Check out the January 2021 NCCI edits for PTs, OTs, and SLPs. 3 min. read March 5, 2021 Blog Post Author . In fact, last year, CMS published to its NCCI edit pairs—all of which impacted rehab therapists. And in January of this year, CMS was back at it again, deleting edit pairs and making retroactive changes that, while beneficial to rehab therapists, are still liable to create a paperwork pileup. Not sure what those changes are? No worries—let’s walk through them together. CMS added some NCCI edit pairs and deleted others retroactive to December 31, 2019. CMS added some NCCI edit pairs and deleted others retroactive to December 31, 2019. For the most part, CMS didn’t add any new CCI edit pairs that were relevant to PTs and OTs this year—though SLPs saw some updates to their CPT code repertoire. The pairs in the following table were added as of January 1, 2021. Column 1DescriptionColumn 2 (y=use modifier 59; n=do not bill in combination with code from Column 192526Treatment of Swallowing Dysfunction69705y; 69706y92610Evaluation of Swallowing69705y; 69706y92611Modified Swallow Study69705y; 69706y92612Flexible Endoscopic Eval of Swallowing69705y; 69706y92614Flexible Endoscopic Evaluation; Laryngeal Sensory Testing by Cine or Video Recording69705y; 69706y92616Flexible Endoscopic Evaluation of Swallowing and Laryngeal Sensory Testing by Cine or Video Recording69705y; 69706y In addition to introducing some new NCCI edit pairs, CMS deleted many previous pairs that were relevant to PTs and OTs. This is a big win, as many of the deleted edit pairs are commonly billed together. The pairs in the following table were deleted retroactive to December 31, 2019, unless otherwise indicated. Column 1DescriptionColumn 2 (y=use modifier 59; n=do not bill in combination with code from Column 197110Therapeutic Exercises97164y; 97168y97112Neuromuscular Re-Education97164y; 97168y97113Aquatic Therapy/Exercise97164y; 97168y97116Gait Training97164y; 97168y97140 Manual Therapy97164y; 97168y; 97530y97150Group Therapy97164y; 97168y97161* PT Evaluation: Low Complexity97140y97162*PT Evaluation: Moderate Complexity97140y97163*PT Evaluation: High Complexity97140y97165*OT Evaluation: Low Complexity97140y97166*OT Evaluation: ModerateComplexity97140y97167*OT Evaluation: High Complexity97140y97530Therapeutic Activities97113y; 97116y; 97164y; 97168y * = Deleted retroactive to January 1, 2020. Download your NCCI Edit Chart. Want an updated, printable, easy-to-reference PDF of NCCI edits? Enter your email address below, and we’ll send it your way. Comments Email Required Invalid Email You got it! The download you requested will be sent to you in a few minutes.
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