Updates for CPT for 2011 Part I

Transcription

1 Updates for CPT for 2011 Part I Presented by Alice Marie Reybitz, RN, BA, CPC, CPC-H, CPC-I H 1 Objectives What codes were added, revised, or deleted Why were these codes added, revised, or deleted How will it effect your office Tips for staying compliant Which codes will affect the reimbursement 2 1

2 Overview and Introduction Each November we are given the new CPT codes They become effective January 1 st. Codes are utilized based on the date of service The information presented here was current as of the air date 3 New Additions to the CPT Book E/M Tables Color Coded Table of Contents in EACH Section Numbers Out of Sequence Coding Tip boxes 4 2

3 E/M Guidelines E/M revisions for 2011 include many time component clarifications: Intra-service time in inpatient settings Intra-service time in outpatient settings A restatement that Time shall be considered the key factor in leveling when counseling/coordination of care dominate the encounter Of course this MUST be documented thoroughly 5 E/M Codes Subsequent Observation Care got the biggest make over

4 Anesthesia Guidelines Anesthesia Guidelines got no makeover this year 7 Anesthesia Codes No new codes this year 8 4

5 Surgery Section Overview General Revision in fine needle biopsy 9 Debridement Integumentary System

6 Musculoskeletal System Incision deleted revised Introduction revised Grafts Musculoskeletal System Fracture/Dislocation Arthrodesis Spinal Instrumentation

7 Excision Musculoskeletal System 13 Arthroscopy Musculoskeletal System 14 7

8 Code Clinical Example 20 year old male, football injury Anti-Inflammatory Drugs and steroid injection brought little or no relief MRI revealed acetabular tear of labrum Surgery to repair the labrum 15 Endoscopy Respiratory System

9 Code Clinical Example 40 year old male patient Four months of medical management Nasal Endoscope to assist with guidewire and balloon catheter placement Dilation accomplished with the balloon to widen the ostium space 17 Cardiovascular System Cardiac Valves Other Complex Cardiac Anomolies

10 Cardiovascular System Thoracic Aortic Aneurysm Endovascular Repair of Iliac Aneurysm Cardiovascular System Transluminal Angioplasty , Deleted T-0238T New 20 10

11 Cardiovascular System Transluminal Angioplasty Transluminal Atherectomy These codes were deleted all together 21 Cardiovascular System Transcatheter Procedures

12 Cardiovascular System Endovascular Revascularization (Open, Percutaneous, Transcatheter) Code Clinical Example 72 year old diabetic female Presenting symptom, gangrenous toes on the left foot Ultrasound and other studies reveal the tibial peroneal occlusions and stenoses Balloon dilation performed to open vessels 24 12

13 Cardiovascular System Lymph Nodes and Lymphatic Channels Cardiovascular System Diaphragm Deleted because of the nature of the hernia repairs, whether esophageal, transabdominal. or gastric 26 13

14 Digestive System Special Mention of Coding Tip Those pesky colonoscopies 27 Digestive System Esophagus Repair 43324, deleted

15 Clinical Example Code year old female, hiatal hernia Unresponsive to medical treatment Referred for repair of hernia 29 Excision deleted revised Introduction Digestive System 30 15

16 Code Clinical Example Special note for the drugs Drugs are used to stimulate the gastric flow These may be charged The fluid used to administer these drugs may not be charged 31 Incision Introduction Laparoscopy Digestive System 32 16

17 Digestive System Introduction, Revision, Removal deleted Urinary System Excision Laparoscopy Urethra/Other Procedures Laparoscopy

18 Urinary System Prostate/Other Procedures Introduction-Female System Nervous System Skull, Meninges, and Brain deleted 36 18

19 Nervous System Introduction/Injection of Anesthetic Agent Neurostimulators deleted revised Nervous System 38 19

20 Chemodenervation Neuroplasty Nervous System 39 Eye new new revised new new revised Special Senses 40 20

21 Code Clinical Example 25 year old female, status post chemical burn of the right eye Topical and systemic medications have failed Decision to apply amniotic membrane to advance lack of corneal healing 41 Special Senses Ear Labyrinthotomy, transcanal Labyrinthotomy, mastoidectomy 42 21

22 Operating Microscope Rewording in the guidelines for code 69990, the add on code for the operating microscope 43 Conclusion Covered the changes to E/M Covered the changes to Anesthesia Covered changes to Surgery Covered changes to the Specialties 44 22

23 CPT Changes 2011, Part I alice.reybitz@aapc.com , ext