Important Information Regarding New CCI Edits from CMS

Effective January 1st, 2020 CMS implemented new CCI edits.  Included in the new set of edits are several significant changes for Therapy

  • CPT codes 97150 and 97530 are now listed as a Column 1 code with all of the PT and OT evaluation and reevaluation codes (97161-97168) and are not permitted to be billed on the same day as a PT or OT evaluation
  • There is a new edit requiting a modifier 59 for CPT 97140 when billed with PT or OT evaluation
Raintree has included these new CCI edits in our quarterly update that is available in our current service packs.  Once installed you must access the appropriate financial class coding edits to import the new table of edits.