Sample. Current Procedural Coding Expert ICD-10. CPT codes with Medicare essentials enhanced for accuracy. Supports HIPAA Compliance EXPERT
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1 EXPERT Current Procedural Coding Expert CPT codes with Medicare essentials enhanced for accuracy Supports HIPAA Compliance 2017 a ICD-10 A full suite of resources including the latest code set, mapping products, and expert training to help you make smooth transition.
2 Contents Contents Introduction...i Getting Started with Current Procedural Coding Expert... i Guidelines... i Resequencing of CPT Codes... i Code Ranges for Medicare Billing... ii Icons... ii Appendixes... v Anatomical Illustrations... vii Body Planes and Movements... vii Integumentary System... viii Musculoskeletal System... ix Musculoskeletal System... x Musculoskeletal System... xi Musculoskeletal System... xii Musculoskeletal System... xiii Musculoskeletal System... xiv Respiratory System... xv Arterial System... xvi Arterial System... xvii Arterial System...xviii Venous System... xix Venous System... xx Lymphatic System... xxi Lymphatic System... xxii Digestive System... xxiii Digestive System... xxiv Genitourinary System... xxv Genitourinary System... xxvi Endocrine System...xxvii Endocrine System...xxviii Nervous System... xxix Nervous System... xxx Eye... xxxi Ear and Lacrimal System... xxxii Index...Index 1 Tabular...1 Anesthesia... 1 Integumentary...12 Musculoskeletal System...33 Respiratory System...96 Cardiovascular System Digestive System Urinary System Genital System Endocrine System Nervous System Eye and Ocular Adnexa Radiology Pathology and Laboratory Medicine Evaluation & Management Category II Codes Category III Codes Appendix A Modifiers CPT Modifiers Modifiers Approved for Ambulatory Surgery Center (ASC) Hospital Outpatient Use Appendix B New, Changed and Deleted Codes New Codes Changed Codes Deleted Codes AMA Icon Changes Appendix C Evaluation and Management Extended Guidelines Appendix D Crosswalk of Deleted Codes Appendix E Resequenced Codes Appendix F Add-on Codes, Modifier 51 Exempt, Optum Modifier 51 Exempt, Modifier 63 Exempt, and Moderate Sedation Codes Add-on Codes AMA Modifer 51 Exempt Codes Modifier 63 Exempt Codes Moderate Sedation Codes Optum Modifier 51 Exempt Codes Appendix G Pub 100 References Medicare IOM references Appendix H Physician Quality Reporting System (PQRS) Appendix I Medically Unlikely Edits (MUEs) Professional Professional OPPS Appendix J Inpatient Only Procedures Appendix K Place of Service and Type of Service Appendix L Multianalyte Assays with Algorithmic Analyses Appendix M Glossary Appendix N Listing of Sensory, Motor, and Mixed Nerves. 703 Motor Nerves Assigned to Codes and Sensory and Mixed Nerves Assigned to Codes Appendix O Vascular Families Appendix P Interventional Radiology Illustrations Normal Aortic Arch and Branch Anatomy Transfemoral Approach Superior and Inferior Mesenteric Arteries and Branches Portal System Renal Artery Anatomy Approach Upper Extremity Arterial Anatomy Transfemoral or Contralateral Approach Lower Extremity Arterial Anatomy Contralateral, Axillary or Brachial Approach Portal System Coronary Arteries Anterior View Left Heart Catheterization Heart Conduction System Optum360, LLC CPT 2016 American Medical Association. All Rights Reserved. i
3 Current Procedural Coding Expert Anatomical Illustrations Respiratory System Left main bronchus Pericardium Sternum Diaphragm Abdominal esophagus Lateral crus Septal Nose Nasal bones Respiratory Lateral nasal s Septal Medial crus Esophagus Aorta L1 T5 Paranasal Sinuses Greater alar Superior Inferior Nasal cavity Nasopharynx Oropharynx Hypopharynx Bronchi Pulmonary arterial trunk Vocal cord Right lung (three s) Pharynx Ethmoid air cells (sinus) Superior Inferior Lungs Auditory tube Nasal Turbinates Epiglottis Larynx Mid frontal cutaway view sinus Left lung (two s) Eye orbit Anatomical Illustrations Frontal Ethmoid Sphenoid Upper Upper Frontal Ethmoid Sphenoid Lower Diaphragm Lower 2016 Optum360, LLC CPT 2016 American Medical Association. All Rights Reserved. xv
4 11462 Integumentary System Integumentary System Excision of skin and subcutaneous tissue for hidradenitis, excised diameter 1.1 to 2.0 cm inguinal; with simple or intermediate repair FUD FUD 090 Tgec with complex repair excised diameter 2.1 to 3.0 cm FUD 090 Tgec FUD Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate excised diameter 3.1 to 4.0 cm repair FUD FUD 090 Tg with complex repair excised diameter over 4.0 cm FUD 090 Tge FUD Skin Lesion Removal: Malignant Excision, malignant lesion including margins, face, ears, 1 Biopsy on same lesion eyelids, nose, lips; excised diameter 0.5 cm or less Excision of additional margin at same operative session Full thickness removal including margins Lesion measurement before excision at largest diameter plus margin Local anesthesia FUD Simple, nonlayered closure Destruction ( ) excised diameter 0.6 to 1.0 cm Code also complex closure ( ) Code also each separate lesion Code also intermediate closure ( ) Code also modifier 58 if re-excision is performed during postoperative period FUD 010 Excision of additional margin at subsequent operative session ( ) Code also reconstruction ( , ) Do not report with adjacent tissue transfer. Report only adjacent tissue transfer code. ( ) excised diameter 1.1 to 2.0 cm Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less FUD FUD ,Jul,12-14; 2012,May,13; 2012,Jan,15-42; 2011,Jan,11; 2010,Apr,3-4; 2010,Jan, excised diameter 2.1 to 3.0 cm excised diameter 0.6 to 1.0 cm FUD FUD ,Jul,12-14; 2012,May,13; 2012,Mar,4-7; 2010,Apr,3-4; 2010,Jan, excised diameter 1.1 to 2.0 cm excised diameter 3.1 to 4.0 cm FUD ,Jul,12-14; FUD excised diameter 2.1 to 3.0 cm FUD excised diameter over 4.0 cm 2012,Jul,12-14; excised diameter 3.1 to 4.0 cm FUD FUD ,Jul,12-14; excised diameter over 4.0 cm 2012,May,13; 2012,Jan,15-42; 2011,Jan,11; 2010,Apr,3-4; 2010,Jan, FUD Nails and Supporting Structures CMS: ,15,290 Foot Care 2012,Jul,12-14; 2 Drainage of paronychia or onychia ( ) Excision, malignant lesion including margins, scalp, neck, Trimming of nondystrophic nails, any number hands, feet, genitalia; excised diameter 0.5 cm or less FUD FUD ,Jul,12-14; excised diameter 0.6 to 1.0 cm FUD Debridement of nail(s) by any method(s); 1 to FUD or more FUD 000 b/f PC/TC Comp Only AMA: CPT Asst 16 g-w ASC Pmt CMS: Pub 100 Medicare (Red Text) c Bilateral : Male Only ; Female Only 5 Facility RVU 6 Non-Facility RVU A-Y OPPSI d/e Surg Assist Allowed / w/doc 4 Lab Crosswalk 3 Radiology Crosswalk CPT 2016 American Medical Association. All Rights Reserved. (Black Text) 2016 Optum360, LLC (Blue Text)
5 Current Procedural Coding Expert Appendix O Vascular Families First Order Second Order Branch Third Order Branch Renal Testicular/Ovarian Lumbar Inferior Mesenteric Sacral Common Iliac Left Colic Sigmoid Internal Iliac External Iliac Inferior Suprarenal Common Rectosigmoid Superior Rectal Iliolumbar Lateral Sacral Superior Gluteal Umbilical Superior Vesical Obturator Inferior Vesical Rectal Inferior Rectal Internal Pudendal Inferior Gluteal Inferior Epigastric Deep Circumflex Iliac Profunda Femoris Deep External Pudendal Superficial External Pudendal Ascending Lateral Circumflex Descending Lateral Circumflex Transverse Lateral Circumflex Superficial Beyond Third Order Branches Cremasteric Pubic Ascending Deep Circumflex Iliac Medial Descending Perforating Branches Lateral Descending Lateral Circumflex Geniculate Popliteal Anterior Tibial Peroneal Posterior Tibial Appendix O Vascular Families Right and Left Main Pulmonary Arteries (Venous Selective) Reference: Kadir S. Atlas of Normal and Variant Angiographic Anatomy. Philadelphia, Pa: WB Saunders Co; Optum360, LLC 2016 American Medical Association. All Rights Reserved. 707
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