CMS recently released a file that stated the National Correct Coding Initiative (NCCI) Medically Unlikely Edit (MUE) for add-on code 92972, percutaneous coronary intravascular lithotripsy, had been set to allow payment for just one unit, as of April 1, 2024, which is inconsistent with clinical practice. SCAI sent an appeal requesting the number of units per day to be increased to better align with clinical use of IVL. CMS agreed to increase the MUE to three. This change will be made with the October 1, 2024, NCCI edit update and retroactive to April 1, 2024. Physicians may appeal denied claims until the revised edit takes effect.
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