00731 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified 01/01/2018

Transcription

1 00731 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified 01/01/ Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP) 01/01/ Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified 01/01/ Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy 01/01/ Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum 01/01/2018

2 Auditory NEW Revised Deleted Code Description Advice 0485T 0486T Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral Optical coherence tomography (OCT) of middle ear, with interpretation and report; bilateral CPT 2018 adds Category III code 0485T and 0486T to track the use and efficacy of optical coherence tomography (OCT) of the middle ear, unilateral and bilateral respectively. OCT is a noninvasive imaging that uses light waves to process and provide three-dimensional images. CPT 2018 adds Category III code 0485T and 0486T to track the use and efficacy of optical coherence tomography (OCT) of the middle ear, unilateral and bilateral respectively. OCT is a noninvasive imaging that uses light waves to process and provide three-dimensional images. 1/1

3 33927 Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy 01/01/ Removal and replacement of total replacement heart system (artificial heart) 01/01/ Removal of a total replacement heart system (artificial heart) for heart transplantation (List separately in addition to code for primary procedure) 01/01/ Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; 01/01/ /01/ /01/2018

4 for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation) Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, traumatic disruption) 01/01/ /01/ /01/ /01/ /01/2018

5 34709 Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code for primary procedure) Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; initial vessel treated Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; each additional vessel treated (List separately in addition to code for primary procedure) Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation 01/01/ /01/ /01/ /01/ Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral (List separately in addition to code for primary procedure) 01/01/ Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (List separately in addition to code for primary procedure) 01/01/2018

6 34715 Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) 01/01/ Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (List separately in addition to code for primary procedure) 01/01/ Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein) 01/01/ Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg 01/01/ Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated 01/01/ Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure) 01/01/2018

7 38222 Diagnostic bone marrow; biopsy(ies) and aspiration(s) 01/01/ Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed 01/01/2018

8 Category II NEW Revised Deleted Code Description Advice 0479T 0480T 0481T 0482T Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part thereof (List separately in addition to code for primary procedure) Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed Absolute quantitation of myocardial blood flow, positron emission tomography (PET), rest and stress (List CPT 2018 adds category III codes 0479T and +0480T to report the creation of openings or windows (fenestrations) in burns and traumatic scars in infants and children using a fractional ablative laser technique. The burn or scar tissue is first destroyed and then an opening is created surgically to drain the fluid. Use this code to report for the treatment of the first 100 sq cm or 1 percent of body surface area (BSA) in infants and children. For each additional 100 sq cm or 1 percent of BSA, report +0480T in addition to this code. CPT 2018 adds category III codes 0479T and +0480T to report the creation of openings or windows (fenestrations) in burns and traumatic scars in infants and children using a fractional ablative laser technique. The burn or scar tissue is first destroyed and then an opening is created surgically to drain the fluid. Use +0480T to report treatment of the each additional 100 sq cm or 1 percent of body surface area (BSA) in addition to 0479T for the first 100 sq cm or 1 percent of total BSA. CPT 2018 adds Category III code 0481T for autologous white blood cell (WBC) concentrate injection, at any location by imaging guidance. It also includes harvesting and preparation. Autologous means that blood or some of its components are reinfused into the same patient from which the blood was removed. White blood cells help fight infections, so a patient with a compromised immune system, such as one undergoing chemotherapy for cancer, may have a low white blood cell count and be particularly vulnerable to infection. Injections or infusions of white blood cells are rare because WBCs remain viable for only a few hours in the blood. This code was added to track the use and efficacy of this rare procedure. This code will be effective beginning January 1, CPT 2018 adds Category III code +0482T as an add-on code to be reported with CPT or on the same day. Measuring myocardial blood flow with PET helps provide a better 1/8

9 0483T 0484T 0485T 0486T separately in addition to code for primary procedure) Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical) Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral Optical coherence tomography (OCT) of middle ear, with interpretation and report; bilateral assessment of heart disease and overcome shortcomings of visual method. In this procedure, a radioactive tracer is instilled or injected into the patient, a PET scan performed with the patient at rest and under stress, and myocardial blood flow is analyzed and quantified (measured) using a computer. The 2018 code set adds 0483T and 0484T were added to track the use and efficacy of transcatheter mitral valve replacement (MVR). Unlike transcatheter aortic valve replacement, which is an established procedure, MVR via a catheter remains an emerging technology. For 0483T, the provider makes a small incision through the skin, inserts a catheter, and threads it through the vessel to the left ventricle of the heart. He implants an artificial valve between the left ventricle and atrium. The procedure may require puncture of the septum between the two chambers. For 0484T, the provider inserts the catheter after opening the chest (thoracotomy) and approaches the valve through the apex (top) of the ventricle (transapical approach). The 2018 code set adds 0483T and 0484T were added to track the use and efficacy of transcatheter mitral valve replacement (MVR). Unlike transcatheter aortic valve replacement, which is an established procedure, MVR via a catheter remains an emerging technology. For 0483T, the provider makes a small incision through the skin, inserts a catheter, and threads it through the vessel to the left ventricle of the heart. He implants an artificial valve between the left ventricle and atrium. The procedure may require puncture of the septum between the two chambers. For 0484T, the provider inserts the catheter after opening the chest (thoracotomy) and approaches the valve through the apex (top) of the ventricle (transapical approach). CPT 2018 adds Category III code 0485T and 0486T to track the use and efficacy of optical coherence tomography (OCT) of the middle ear, unilateral and bilateral respectively. OCT is a noninvasive imaging that uses light waves to process and provide three-dimensional images. CPT 2018 adds Category III code 0485T and 0486T to track the use and efficacy of optical coherence tomography (OCT) of the middle ear, unilateral and bilateral respectively. OCT is a noninvasive imaging that uses light waves to process and provide three-dimensional images. 2/8

10 0487T 0488T 0489T 0490T 0491T Biomechanical mapping, transvaginal, with report Preventive behavior change, online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum, provided to an individual, per 30 days Autologous adiposederived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting, isolation and preparation of harvested cells including incubation with cell dissociation enzymes, removal of non-viable cells and debris, determination of concentration and dilution of regenerative cells Autologous adiposederived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; first 20 sq cm or less CPT 2018 adds Category III code 0487T to track the use and efficacy of a relatively new, but FDAapproved technology, i.e. transvaginal biomechanical mapping. In this procedure, the provider inserts a probe with tactile sensors on its surface into the vagina. The probe senses pelvic muscle contractions and relaxation and sends the data to a computer where the data is interpreted and pelvic floor muscle function mapped. The technology helps diagnose vaginal and pelvic floor abnormalities. CPT 2018 adds Category III code 0488T to report a structured diabetes prevention program that addresses stress, nutrition, weight management, and exercise, delivered online or via electronic technology by a lifestyle coach who has completed nationally recognized training. CPT 2018 adds Category III code 0489T and 0490T to track the use and efficacy of autologous adipose-derived regenerative therapy for hand scleroderma. Use 0489T for a single injection; to report multiple injections, use 0490T. Scleroderma is a type of autoimmune disease characterized by hardening and thickening of the skin and causing skin tightness; it can also involve connective tissue and vessels and affect joints and organs. The procedure uses fat cells taken (harvested) from the patient; the cells are processed to a certain concentration and dilution and returned to the patient. CPT 2018 adds Category III code 0489T and 0490T to track the use and efficacy of autologous adipose-derived regenerative therapy for hand scleroderma. Use 0489T for a single injection; to report multiple injections, use 0490T. Scleroderma is a type of autoimmune disease characterized by hardening and thickening of the skin and causing skin tightness; it can also involve connective tissue and vessels and affect joints and organs. The procedure uses fat cells taken (harvested) from the patient; the cells are processed to a certain concentration and dilution and returned to the patient. The 2018 code set adds 0491T and +0492T to track the use and efficacy of full field and fractional, noncontact laser ablation of open wounds. Fractional laser ablation is an accepted technology for skin resurfacing and scar revision, but its use to 3/8

11 promote healing of open wounds is still under investigation. In this procedure, the provider uses laser ablation (heat produced by adjustable focused light energy) to destroy necrotic (dead) tissue and promote granulation in an open wound. Report 0491T for treatment of the first 20 sq cm or less per day and +0492T, in addition to 0491T, for each additional 20 sq cm or less. 0492T 0493T 0494T Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) Near-infrared spectroscopy studies of lower extremity wounds (eg, for oxyhemoglobin measurement) Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservation of the allograft prior to implantation, when performed The 2018 code set adds 0491T and +0492T to track the use and efficacy of full field and fractional, noncontact laser ablation of open wounds. Fractional laser ablation is an accepted technology for skin resurfacing and scar revision, but its use to promote healing of open wounds is still under investigation. In this procedure, the provider uses laser ablation (heat produced by adjustable focused light energy) to destroy necrotic (dead) tissue and promote granulation in an open wound. Report 0491T for treatment of the first 20 sq cm or less per day and +0492T, in addition to 0491T, for each additional 20 sq cm or less. The 2018 code set adds 0493T to track the use and efficacy of near-infrared spectroscopy to measure oxygen saturation in the tissues of lower extremity wounds. Near-infrared spectroscopy uses the absorption and emission of near-infrared spectrum photons reflected by wound tissue, in this case, to assess the amount of oxygen in the tissues. Oxygen is carried by hemoglobin in the blood and is critical to wound healing, so being able to assess oxygenation in wound tissues is predictive of healing. Of note, 0286T with the same descriptor was retired in The 2018 code set adds 0494T to report the surgical preparation and preservation of cadaver donor lung(s) including attaching the lung to an organ perfusion system and its removal for implantation. Donor organ perfusion technology uses ventilation and perfusion of the donor lung to reproduce the in vivo (in the body) environment, increasing its viability for a longer period. The system also assesses the function of marginal lungs and expands the number of acceptable donor lungs. See also 0495T and +0496T for monitoring of donor lung function after attachment to an organ perfusion system by a qualified healthcare professional using various parameters. 0495T Initiation and monitoring marginal (extended) cadaver donor lung(s) The 2018 code set add 0495T and 0496T to report marginal donor lung monitoring by a qualified 4/8

12 0496T 0497T organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; first two hours in sterile field Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; each additional hour (List separately in addition to code for primary procedure) External patientactivated, physician- or other qualified health care professionalprescribed, electrocardiographic rhythm derived event recorder without 24 hour attended monitoring; inoffice connection healthcare professional. Report 0495T for the first two hours of monitoring, using various parameters, including visual physiologic assessment, various laboratory pulmonary function studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report +0496T with 0495T. The code set also adds 0494T to report the surgical preparation and preservation of cadaver donor lung(s) including attaching the lung to an organ perfusion system and its removal for implantation. Donor organ perfusion technology uses ventilation and perfusion of the donor lung to reproduce the in vivo (in the body) environment, increasing its viability for a longer period. The system also assesses the function of marginal lungs and expands the number of acceptable donor lungs. The 2018 code set add 0495T and +0496T to report marginal donor lung monitoring by a qualified healthcare professional. Report 0495T for the first two hours of monitoring, using various parameters, including visual physiologic assessment, various laboratory pulmonary function studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report +0496T with 0495T. The code set also adds 0494T to report the surgical preparation and preservation of cadaver donor lung(s) including attaching the lung to an organ perfusion system and its separation from the organ perfusion system for implantation. Donor organ perfusion technology uses ventilation and perfusion of the donor lung to reproduce the in vivo (in the body) environment, increasing its viability for a longer period. The system also assesses the function of marginal lungs and expands the number of acceptable donor lungs. The 2018 code set adds 0497T and 0498T to electrocardiographic rhythm-derived event recorder monitoring activated by the patient and worn externally. Report 0497T for the prescription and inoffice connection for the device and 0498T for review and interpretation for a 30-day period with at least one patient-generated triggered event. The purpose of these devices is to track the occurrence and frequency of rhythm disturbances of the heart. In this case, the patient presses a button when he senses a rhythm disturbance to initiate the recording and to send the recording via an in-office connection. There are devices which continuously record the patient s heart rhythm and other devices 5/8

13 that are auto-sensing, but this device initiates a recording when activated by the patient. 0498T 0499T 0500T 0501T External patientactivated, physician- or other qualified health care professionalprescribed, electrocardiographic rhythm derived event recorder without 24 hour attended monitoring; review and interpretation by a physician or other qualified health care professional per 30 days with at least one patientgenerated triggered event Cystourethroscopy, with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis, including fluoroscopy, when performed Infectious agent detection by nucleic acid (DNA or RNA), Human Papillomavirus (HPV) for five or more separately reported high-risk HPV types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) (ie, genotyping) Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography The 2018 code set adds 0497T and 0498T to electrocardiographic rhythm-derived event recorder monitoring activated by the patient and worn externally. Report 0497T for the prescription and inoffice connection for the device and 0498T for review and interpretation for a 30-day period with at least one patient-generated triggered event. The purpose of these devices is to track the occurrence and frequency of rhythm disturbances of the heart. In this case, the patient presses a button when he senses a rhythm disturbance to initiate the recording and to send the recording via an in-office connection. There are other types of devices which continuously record the patient s heart rhythm and other devices that are auto-sensing, but this device iniatiates the recording when the patient activates it. The 2018 code set adds 0499T to track the use and efficacy of instillation of a drug through the urethra during cystourethroscopy and mechanical dilation for stricture or stenosis. Drugs such as steroids have been instilled into the urethra following surgical treatment of a stricture or stenosis to promote healing and prevent scarring or repeat stricture. Cystourethroscopy is a procedure in which the provider views and examines the bladder and urethra using a flexible or rigid tube with a camera at the end that is inserted through the urethra into the bladder to examine the urethra and urinary tract. Instruments such as dilators can be inserted through the scope to dilate a narrowed urethra. The procedure is sometimes done using fluoroscopic guidance, a live X-ray where the image appears on a monitor. CPT 2018 adds 0500T as a Category III code for human papillomavirus (HPV) genotyping that identifies five or more separately reported high-risk HPV types such as the examples given in the code descriptor. Distinguish 0500T from similar codes for infectious agent antigen detection by nucleic acid 87624, which you should reserve for reporting four or fewer high risk HPV types, or 87625, which you should reserve for reporting high-risk HPV types 16, 18 and 45. CPT 2018 adds four Category III codes 0501T- 0504T to track the use and efficacy of noninvasive estimated coronary fractional flow reserve (FFR) computed tomography (CT), an emerging 6/8

14 0502T 0503T data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; analysis of fluid dynamics and technology. FFR-CT is a diagnostic imaging technique which helps diagnose intermediate coronary artery stenosis and improves decisionmaking. FFR-CT provides a detailed description of the blood flow in heart vessels with anatomical details. Report 0501T for the full study imaging, analysis, estimated FFR model generation, and reconciliation of anatomical data with the estimated FFR as well as interpretation and report. For components of the study, report 0502T for data preparation and transmission, 0503T for fluid dynamics analysis, simulated maximal coronary hyperemia, and estimated FFR model generation, and 0504T for reconciliation of anatomical data with the estimated FFR and interpretation and report. Codes 0502T-0504T cannot be reported in conjunction with 0501T; no code should be reported more than once per coronary CT angiography. CPT 2018 adds four Category III codes 0501T- 0504T to track the use and efficacy of noninvasive estimated coronary fractional flow reserve (FFR) computed tomography (CT), an emerging technology. FFR-CT is a diagnostic imaging technique which helps diagnose intermediate coronary artery stenosis and improves decisionmaking. FFR-CT provides a detailed description of the blood flow in heart vessels with anatomical details. Report 0501T for the full study imaging, analysis, estimated FFR model generation, and reconciliation of anatomical data with the estimated FFR as well as interpretation and report. For components of the study, report 0502T for data preparation and transmission, 0503T for fluid dynamics analysis, simulated maximal coronary hyperemia, and estimated FFR model generation, and 0504T for reconciliation of anatomical data with the estimated FFR and interpretation and report. Codes 0502T-0504T cannot be reported in conjunction with 0501T; no code should be reported more than once per coronary CT angiography. CPT 2018 adds four Category III codes 0501T- 0504T to track the use and efficacy of noninvasive estimated coronary fractional flow reserve (FFR) computed tomography (CT), an emerging technology. FFR-CT is a diagnostic imaging technique which helps diagnose intermediate coronary artery stenosis and improves decisionmaking. FFR-CT provides a detailed description of the blood flow in heart vessels with anatomical details. Report 0501T for the full study imaging, 7/8

15 0504T simulated maximal coronary hyperemia, and generation of estimated FFR model Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report analysis, estimated FFR model generation, and reconciliation of anatomical data with the estimated FFR as well as interpretation and report. For components of the study, report 0502T for data preparation and transmission, 0503T for fluid dynamics analysis, simulated maximal coronary hyperemia, and estimated FFR model generation, and 0504T for reconciliation of anatomical data with the estimated FFR and interpretation and report. Codes 0502T-0504T cannot be reported in conjunction with 0501T; no code should be reported more than once per coronary CT angiography. CPT 2018 adds four Category III codes 0501T- 0504T to track the use and efficacy of noninvasive estimated coronary fractional flow reserve (FFR) computed tomography (CT), an emerging technology. FFR-CT is a diagnostic imaging technique which helps diagnose intermediate coronary artery stenosis and improves decisionmaking. FFR-CT provides a detailed description of the blood flow in heart vessels with anatomical details. Report 0501T for the full study imaging, analysis, estimated FFR model generation, and reconciliation of anatomical data with the estimated FFR as well as interpretation and report. For components of the study, report 0502T for data preparation and transmission, 0503T for fluid dynamics analysis, simulated maximal coronary hyperemia, and estimated FFR model generation, and 0504T for reconciliation of anatomical data with the estimated FFR and interpretation and report. Codes 0502T-0504T cannot be reported in conjunction with 0501T; no code should be reported more than once per coronary CT angiography. 8/8

16 Category III NEW Revised Deleted Code Description Advice 0479T 0480T 0481T 0482T Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part thereof (List separately in addition to code for primary procedure) Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed Absolute quantitation of myocardial blood flow, positron emission tomography (PET), rest and stress (List CPT 2018 adds category III codes 0479T and +0480T to report the creation of openings or windows (fenestrations) in burns and traumatic scars in infants and children using a fractional ablative laser technique. The burn or scar tissue is first destroyed and then an opening is created surgically to drain the fluid. Use this code to report for the treatment of the first 100 sq cm or 1 percent of body surface area (BSA) in infants and children. For each additional 100 sq cm or 1 percent of BSA, report +0480T in addition to this code. CPT 2018 adds category III codes 0479T and +0480T to report the creation of openings or windows (fenestrations) in burns and traumatic scars in infants and children using a fractional ablative laser technique. The burn or scar tissue is first destroyed and then an opening is created surgically to drain the fluid. Use +0480T to report treatment of the each additional 100 sq cm or 1 percent of body surface area (BSA) in addition to 0479T for the first 100 sq cm or 1 percent of total BSA. CPT 2018 adds Category III code 0481T for autologous white blood cell (WBC) concentrate injection, at any location by imaging guidance. It also includes harvesting and preparation. Autologous means that blood or some of its components are reinfused into the same patient from which the blood was removed. White blood cells help fight infections, so a patient with a compromised immune system, such as one undergoing chemotherapy for cancer, may have a low white blood cell count and be particularly vulnerable to infection. Injections or infusions of white blood cells are rare because WBCs remain viable for only a few hours in the blood. This code was added to track the use and efficacy of this rare procedure. This code will be effective beginning January 1, CPT 2018 adds Category III code +0482T as an add-on code to be reported with CPT or on the same day. Measuring myocardial blood flow with PET helps provide a better 1/8

17 0483T 0484T 0485T 0486T separately in addition to code for primary procedure) Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical) Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral Optical coherence tomography (OCT) of middle ear, with interpretation and report; bilateral assessment of heart disease and overcome shortcomings of visual method. In this procedure, a radioactive tracer is instilled or injected into the patient, a PET scan performed with the patient at rest and under stress, and myocardial blood flow is analyzed and quantified (measured) using a computer. The 2018 code set adds 0483T and 0484T were added to track the use and efficacy of transcatheter mitral valve replacement (MVR). Unlike transcatheter aortic valve replacement, which is an established procedure, MVR via a catheter remains an emerging technology. For 0483T, the provider makes a small incision through the skin, inserts a catheter, and threads it through the vessel to the left ventricle of the heart. He implants an artificial valve between the left ventricle and atrium. The procedure may require puncture of the septum between the two chambers. For 0484T, the provider inserts the catheter after opening the chest (thoracotomy) and approaches the valve through the apex (top) of the ventricle (transapical approach). The 2018 code set adds 0483T and 0484T were added to track the use and efficacy of transcatheter mitral valve replacement (MVR). Unlike transcatheter aortic valve replacement, which is an established procedure, MVR via a catheter remains an emerging technology. For 0483T, the provider makes a small incision through the skin, inserts a catheter, and threads it through the vessel to the left ventricle of the heart. He implants an artificial valve between the left ventricle and atrium. The procedure may require puncture of the septum between the two chambers. For 0484T, the provider inserts the catheter after opening the chest (thoracotomy) and approaches the valve through the apex (top) of the ventricle (transapical approach). CPT 2018 adds Category III code 0485T and 0486T to track the use and efficacy of optical coherence tomography (OCT) of the middle ear, unilateral and bilateral respectively. OCT is a noninvasive imaging that uses light waves to process and provide three-dimensional images. CPT 2018 adds Category III code 0485T and 0486T to track the use and efficacy of optical coherence tomography (OCT) of the middle ear, unilateral and bilateral respectively. OCT is a noninvasive imaging that uses light waves to process and provide three-dimensional images. 2/8

18 0487T 0488T 0489T 0490T 0491T Biomechanical mapping, transvaginal, with report Preventive behavior change, online/electronic structured intensive program for prevention of diabetes using a standardized diabetes prevention program curriculum, provided to an individual, per 30 days Autologous adiposederived regenerative cell therapy for scleroderma in the hands; adipose tissue harvesting, isolation and preparation of harvested cells including incubation with cell dissociation enzymes, removal of non-viable cells and debris, determination of concentration and dilution of regenerative cells Autologous adiposederived regenerative cell therapy for scleroderma in the hands; multiple injections in one or both hands Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; first 20 sq cm or less CPT 2018 adds Category III code 0487T to track the use and efficacy of a relatively new, but FDAapproved technology, i.e. transvaginal biomechanical mapping. In this procedure, the provider inserts a probe with tactile sensors on its surface into the vagina. The probe senses pelvic muscle contractions and relaxation and sends the data to a computer where the data is interpreted and pelvic floor muscle function mapped. The technology helps diagnose vaginal and pelvic floor abnormalities. CPT 2018 adds Category III code 0488T to report a structured diabetes prevention program that addresses stress, nutrition, weight management, and exercise, delivered online or via electronic technology by a lifestyle coach who has completed nationally recognized training. CPT 2018 adds Category III code 0489T and 0490T to track the use and efficacy of autologous adipose-derived regenerative therapy for hand scleroderma. Use 0489T for a single injection; to report multiple injections, use 0490T. Scleroderma is a type of autoimmune disease characterized by hardening and thickening of the skin and causing skin tightness; it can also involve connective tissue and vessels and affect joints and organs. The procedure uses fat cells taken (harvested) from the patient; the cells are processed to a certain concentration and dilution and returned to the patient. CPT 2018 adds Category III code 0489T and 0490T to track the use and efficacy of autologous adipose-derived regenerative therapy for hand scleroderma. Use 0489T for a single injection; to report multiple injections, use 0490T. Scleroderma is a type of autoimmune disease characterized by hardening and thickening of the skin and causing skin tightness; it can also involve connective tissue and vessels and affect joints and organs. The procedure uses fat cells taken (harvested) from the patient; the cells are processed to a certain concentration and dilution and returned to the patient. The 2018 code set adds 0491T and +0492T to track the use and efficacy of full field and fractional, noncontact laser ablation of open wounds. Fractional laser ablation is an accepted technology for skin resurfacing and scar revision, but its use to 3/8

19 promote healing of open wounds is still under investigation. In this procedure, the provider uses laser ablation (heat produced by adjustable focused light energy) to destroy necrotic (dead) tissue and promote granulation in an open wound. Report 0491T for treatment of the first 20 sq cm or less per day and +0492T, in addition to 0491T, for each additional 20 sq cm or less. 0492T 0493T 0494T Ablative laser treatment, non-contact, full field and fractional ablation, open wound, per day, total treatment surface area; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) Near-infrared spectroscopy studies of lower extremity wounds (eg, for oxyhemoglobin measurement) Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservation of the allograft prior to implantation, when performed The 2018 code set adds 0491T and +0492T to track the use and efficacy of full field and fractional, noncontact laser ablation of open wounds. Fractional laser ablation is an accepted technology for skin resurfacing and scar revision, but its use to promote healing of open wounds is still under investigation. In this procedure, the provider uses laser ablation (heat produced by adjustable focused light energy) to destroy necrotic (dead) tissue and promote granulation in an open wound. Report 0491T for treatment of the first 20 sq cm or less per day and +0492T, in addition to 0491T, for each additional 20 sq cm or less. The 2018 code set adds 0493T to track the use and efficacy of near-infrared spectroscopy to measure oxygen saturation in the tissues of lower extremity wounds. Near-infrared spectroscopy uses the absorption and emission of near-infrared spectrum photons reflected by wound tissue, in this case, to assess the amount of oxygen in the tissues. Oxygen is carried by hemoglobin in the blood and is critical to wound healing, so being able to assess oxygenation in wound tissues is predictive of healing. Of note, 0286T with the same descriptor was retired in The 2018 code set adds 0494T to report the surgical preparation and preservation of cadaver donor lung(s) including attaching the lung to an organ perfusion system and its removal for implantation. Donor organ perfusion technology uses ventilation and perfusion of the donor lung to reproduce the in vivo (in the body) environment, increasing its viability for a longer period. The system also assesses the function of marginal lungs and expands the number of acceptable donor lungs. See also 0495T and +0496T for monitoring of donor lung function after attachment to an organ perfusion system by a qualified healthcare professional using various parameters. 0495T Initiation and monitoring marginal (extended) cadaver donor lung(s) The 2018 code set add 0495T and 0496T to report marginal donor lung monitoring by a qualified 4/8

20 0496T 0497T organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; first two hours in sterile field Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; each additional hour (List separately in addition to code for primary procedure) External patientactivated, physician- or other qualified health care professionalprescribed, electrocardiographic rhythm derived event recorder without 24 hour attended monitoring; inoffice connection healthcare professional. Report 0495T for the first two hours of monitoring, using various parameters, including visual physiologic assessment, various laboratory pulmonary function studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report +0496T with 0495T. The code set also adds 0494T to report the surgical preparation and preservation of cadaver donor lung(s) including attaching the lung to an organ perfusion system and its removal for implantation. Donor organ perfusion technology uses ventilation and perfusion of the donor lung to reproduce the in vivo (in the body) environment, increasing its viability for a longer period. The system also assesses the function of marginal lungs and expands the number of acceptable donor lungs. The 2018 code set add 0495T and +0496T to report marginal donor lung monitoring by a qualified healthcare professional. Report 0495T for the first two hours of monitoring, using various parameters, including visual physiologic assessment, various laboratory pulmonary function studies, and even bronchoscopy and X-ray. For each additional hour of monitoring, report +0496T with 0495T. The code set also adds 0494T to report the surgical preparation and preservation of cadaver donor lung(s) including attaching the lung to an organ perfusion system and its separation from the organ perfusion system for implantation. Donor organ perfusion technology uses ventilation and perfusion of the donor lung to reproduce the in vivo (in the body) environment, increasing its viability for a longer period. The system also assesses the function of marginal lungs and expands the number of acceptable donor lungs. The 2018 code set adds 0497T and 0498T to electrocardiographic rhythm-derived event recorder monitoring activated by the patient and worn externally. Report 0497T for the prescription and inoffice connection for the device and 0498T for review and interpretation for a 30-day period with at least one patient-generated triggered event. The purpose of these devices is to track the occurrence and frequency of rhythm disturbances of the heart. In this case, the patient presses a button when he senses a rhythm disturbance to initiate the recording and to send the recording via an in-office connection. There are devices which continuously record the patient s heart rhythm and other devices 5/8