Angela Clements, CPC, CEMC, COSC Internal Consultant

Transcription

1 Angela Clements, CPC, CEMC, COSC Internal Consultant

2 Disclaimer The following information was put together based on my experience, research and expertise in the coding profession. CPT is a registered trademark of the AMA

3 CPT New Codes 47 Deleted Codes 107 Revised Codes Guideline Changes 47 New Category II Codes 21 New Category III Codes

4 Evaluation and Management Interprofessional telephone/internet assessment and management service provided by a consultative physician including a verbal and written report to the patient s treating/requesting physician or other qualified healthcare professional minutes (do not report less than 5 mins.) minutes minutes minutes or more

5 Evaluation and Management Total body systemic hypothermia in a critically ill neonate per day Selective head hypothermia in a critically ill neonate per day Use in conjunction with 99291, 99292, 99468, 99469

6 Integumentary Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous Includes moderate sedation

7 Integumentary have been deleted Breast Bx with placement of localization device, when performed, and imaging of bx specimen, when performed, percutaneous, first lesion, including stereotactic guidance each additional lesion

8 Integumentary Breast Bx with placement of localization device, when performed, and imaging of bx specimen, when performed, percutaneous, first lesion, including ultrasound guidance each additional lesion

9 Integumentary Breast Bx with placement localization device, when performed, and imaging of bx specimen, when performed, percutaneous, first lesion, including magnetic resonance guidance each additional lesion

10 Integumentary Placement of breast localization device(s) percutaneous, first lesion, including mammographic guidance each additional lesion Placement of breast localization device(s) percutaneous, first lesion, including stereotactic guidance each additional lesion

11 Integumentary Placement of breast localization device(s) percutaneous, first lesion, including ultrasound guidance each additional lesion Placement of breast localization device(s) percutaneous, first lesion, including magnetic resonance guidance each additional lesion

12 Musculoskeletal Removal foreign body, shoulder; deep Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component humeral and glenoid component (eg total shoulder) CPT codes and have been deleted.

13 Cardiovascular (Revision) In 2014, the below codes were revised from Revision or relocation of skin pocket to Relocation of skin pocket. A pocket revision is not separately reportable Relocation of skin pocket for pacemaker Relocation of skin pocket for cardio-defibrillator

14 Cardiovascular Transcatheter aortic valve replacement with prosthetic valve; transaortic exposure (eg left thoracotomy) Replaces 0318T Patients with severe asymptomatic aortic stenosis who are not candidates for open chest surgery

15 Cardiovascular Fenestrated Endovascular Repair of the Visceral and Infrarenal Aorta includes Introduction of guidewire and catheters Angioplasty of target zone Fluoroscopic guidance Diagnostic angiography of aorta and branches Intraprocedural arterial angiography

16 Cardiovascular Endovascular repair of visceral aorta by deployment of a fenestrated visceral aortic endograft and ; including one visceral artery endoprosthesis including two visceral artery enodoprostheses including three visceral artery endoprostheses including four or more

17 Cardiovascular Endovascular repair of visceral aorta and infrarenal abdominal aorta with a fenestrated visceral aortic endograft and concomitant unibody or ; including one visceral artery endoprosthesis including two visceral artery enodoprostheses including three visceral artery endoprostheses including four or more

18 Cardiovascular Stent intrathoracic common carotid or innominate artery by retrograde, via open Stent, open or percutaneous; initial artery each additional artery Stent, open or percutaneous; initial vein each additional vein

19 Cardiovascular Vascular embolization or occlusion, inclusive of all radiological S&I, intraprocedural roadmapping and imaging guidance necessary to complete the intervention; venous, other than hemorrhage

20 Cardiovascular arterial, other than hemorrhage or tumor for tumor organ ischemia or infarction for arterial or venous hemorrhage or lymphatic extravasation

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26 Digestive Image-guided fluid collection drainage by catheter; visceral percutaneous ; peritoneal or retroperitoneal, percuatneous peritoneal or retroperitoneal, transvaginal or transrectal

27 Urinary Cystourethroscopy with lithotripsy including insertion of indwelling ureteral stent

28 Nervous Chemodenervation of muscles; neck muscle(s), excluding muscles of the larynx unilateral (eg, for cervical dystonia, spasmodic torticollis) Append modifier 50 for bilateral procedure Code or when guided by needle electromyography or muscle electrical stimulation. Only report one guidance Chemodenervation of muscles; larynx, unilateral, percutaneous (eg for spasmodic dysphonia), includes guidance by needle electromyography, when performed Append modifier 50 for bilateral procedure Do NOT report guidance of needle or in addition

29 Nervous Chemodenervation of one extremity; 1-4 muscle(s) Do NOT append modifier 50 (+) each additional extremity; 1-4 muscle(s) Code in addition to or Do NOT append modifier 50

30 Nervous Chemodenervation of one extremity; 5 or more muscle(s) Do NOT append modifier 50 (+) each additional extremity, 5 or more muscle(s) Code in addition to Do NOT append modifier 50

31 Nervous Chemodenervation of trunk muscle(s); 1-5 muscle(s) Report once per session Do NOT append modifier or more muscle(s) Report once per session Do NOT append modifier 50

32 Eye Insertion of anterior segment aqueous drainage device, without extrocular reservoir, external approach

33 Auditory Removal impacted cerumen requiring instrumentation, unilateral

34 Radiology Respiratory motion management simulation Use in conjunction with 77295, 77301

35 Pathology and Laboratory Drug assay codes Caffeine Clozapine Everolimus Gabapentin Lamotrigine Levetiracetam Micophenolate Oxcarbazepine Tiagabine Zonisamide

36 Pathology and Laboratory MGMT, methylation analysis Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores Fetal aneuploidy (trisomy 21, 187 and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy each additional separately identifiable antibody per slide

37 Medicine Influenza, trivalent Influenza, quadrivalent, split, preservative free; ages 6-35 months Influenza, quadrivalent, split, preservative free; ages 3 and older Influenza, quadrivalent, split, ages 6-35 months Influenza, quadrivalent, split, ages 3 and older

38 Medicine Evaluation of speech fluency (eg, stuttering, cluttering) Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language) Behavioral and qualitative analysis of voice and resonance SLPs/

39 Medicine Percutaneous transcatheter closure of patent ductus arteriosus Percutaneous transcatheter septal reduction therapy including temporary pacemaker insertion when performed

40 Medicine Mechanical chest wall oscillation to facilitate lung function, per session Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment and instruction(s) for ongoing care, per day

41 Category II 37 New Codes 1 Revision

42 Category III 12 deleted 21 addition

43 Category III 0319T- 0328T Subcutaneous Implantable Defibrillator System 0329T-0339T

44 Next? Make sure you are using a 2014 CPT code book Paper/electronic superbills have they been updated? Staff education

45 Conclusion A summary of code additions, deletions and revisions can be found in Appendix B of the CPT book.

46 Thank you! Angela Clements, CPC, CEMC, COSC Internal Consultant