SCAI, in conjunction with ACC, requested a review of several National Correct Coding Initiative (NCCI) edits that are reducing payments to pediatric cardiologists. While we understand that the purpose of NCCI is to help the Medicare program, many other payers are using the edits for non-Medicare patient populations. We cited examples such as;

a recent edit which precluded the use of CPT code 33210 (Insertion of a temporary transvenous single-chamber pacing catheter) in the same setting as cardiac catheterization. While this is a stand-alone procedure (bundling in payments for ancillary physician services), this should not prevent a provider from performing two stand-alone procedures at the same time.

We have requested a meeting with both Medicare officials and the Medical Director of NCCI to hopefully resolve these concerns. The letter provides more detail. SCAI appreciates the efforts of Drs. Art Lee and Sergio Bartakian in working to resolve these matters. They are SCAI’s representative and alternate representative (respectively) to the AMA’s CPT Editorial Panel.