Errata and Technical Corrections CPT 2014 Date: November 11, 2013

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1 rrata and Technical Corrections CPT 2014 Date: November 11, 2013 The information that follows is sourced to either a publication errata or a technical correction by the CPT ditorial Panel. An errata (denoted as ) for the current edition of the CPT code set will publish information that was approved by the CPT ditorial Panel and inadvertently excluded from the current code set. Technical corrections (denoted as T) are clarifications of original Panel intent for the current code structure. All items below are errata if they are not designated as a technical correction in the right hand column. The order of the entries on this document is by code order. Additionally, each entry shows the date of publication to this document. The links immediately following are provided as a guide to the most recently added items. The effective date for each item is January 1, Updates to this document are made as issues surface requiring clarification. Users are encouraged to sign up on the CPT listserv to receive notification as updates are posted to the AMA website. Most recent entries added to rrata and Technical Corrections - CPT 2014 Revision to the instruction for use of the CPT codebook guidelines Revise to remove esophagus Deleted parenthetical notes for 0256T, 0257T, and 0259T Revise medium descriptor for codes Revise medium descriptor for code Revise medium descriptor for code Revise exclusionary parenthetical note following Revise medium descriptor for code Revision to code 1040F Delete parenthetical note for deleted code 0003T Revision of transplantation and post guidelines and code Technical Correction Revision of chemodenervation guidelines Technical Correction Revision of parenthetical note following Technical Correction Revise short descriptor for code Revise parenthetical preceding

2 rrata and Technical Corrections Front Matter Introduction Instructions for Use of the CPT Codebook Throughout the CPT de set the use of terms such as physician, qualified health care professional, or individual is not intended to indicate that other entities may not report the service. In selected instances, specific instructions may define a service as limited to professionals or limited to other entities (eg, hospital or home health agency). Revise the instructions for use of the CPT codebook guidelines to include missing content define a service as limited to professionals or limited to other entities (eg, hospital or home health agency). Hemic and Lymphatic Systems General Transplantation and Post-Transplantation Cellular Infusions Hematopoietic cell transplantation (HCT) refers to the infusion of hematopoietic progenitor HCT may be autologous (when the HPC donor and recipient are the same person) or allogeneic (when the HPC donor and recipient are not the same person). Code is used to report any autologous transplant while is used to report an allogeneic transplant. In some cases allogeneic transplants involve more than one donor and cells from each donor are infused sequentially whereby one unit of is reported for each donor infused. Code is used to report a donor lymphocyte infusion. Code is used to report a HPC boost from the original allogeneic HPC donor. A lymphocyte infusion or HPC boost can occur days, months or even years after the initial hematopoietic cell transplant. The lymphocyte infusion is used to treat relapse, infection, or post-transplant lymphoproliferative syndrome. HPC boost represents an infusion of hematopoietic progenitor cells from the original donor that is being used to treat a relapse or post-transplant cytopenia(s). Codes 38240, 38242, and should not be reported together on the same date of service. T ffective 10/14/13 If a separately identifiable evaluation and management service is performed on the same date Hematopoietic progenitor cell (HPC); allogeneic transplantation per donor autologous transplantation # HPC boost Revise the transplantation and post-transplantation cellular infusion guidelines by removing the inaccurate statement that HPC boost is used for treatment of relapse, infection, or posttransplant lymphoproliferative syndrome 2

3 rrata and Technical Corrections Digestive System sophagus ndoscopy sophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), esophagus (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures) Revise code removing reference to the term esophagus. Female Genital System Cervix Uteri (For cervicography, use Category III code 0003T) Delete parenthetical note referencing deleted code 0003T. Medicine Cardiovascular Cardiography Codes are appropriate when an order for the test is triggered by an event, the rhythm strip is used to help diagnose the presence or absence of an arrhythmia, and a report is generated. There must be a specific order for an electrocardiogram or rhythm strip followed by a separate, signed, written, and retrievable report. It is not appropriate to use these codes for reviewing the telemetry monitor strips taken from a monitoring system. The need for an electrocardiogram or rhythm strip should be supported by documentation in the patient medical record. (For echocardiography, see ) (For electrocardiogram, 64 leads or greater, with graphic presentation and analysis, see 0178T- 0180T use 93799) lectrocardiogram, routine CG Delete reference to code from the parenthetical note preceding and replace with codes 0178T-0180T. 3

4 rrata and Technical Corrections Nervous System Destruction by Neurolytic Agent (eg, Chemical, Thermal, lectrical or Radiofrequency), Chemodenervation Report 64642, 64643, 64644, once per extremity. Codes 64642, 64643, 64644, can be reported together up to a combined total of four units of service per patient when all four extremities are injected. Report only one base code (64642 or 64644) per session. Report one or more units of additional extremity code(s) (64643 or 64645) for each additional extremity injected. Report or for chemodenervation of muscles of the trunk. T ffective 10/14/13 Trunk muscles include the erector spinae and paraspinal muscles, rectus abdominus and obliques. All other somatic muscles are extremity muscles, head muscles, or neck muscles. (For chemodenervation guided by needle electromyography or muscle electrical stimulation, see 95873, Do not report more than one guidance code for each corresponding chemodenervation of extremity or trunk code) (Do not report modifier 50 in conjunction with 64642, 64643, 64644, 64645, 64646, 64647) Chemodenervation of one extremity; 1-4 muscle(s) Revise the guidelines preceding code to limit injections to reporting of one unit for injection of each additional extremity. Medicine Cardiovascular Cardiac Catheterization Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to code for primary procedure) (Use in conjunction with 93452, 93453, , 93653, 93654) (Do not report in conjunction with 93656) Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (List separately in addition to code for primary procedure) (Use in conjunction with , , 93530, 93531, 93532, 93533, 93563, 93564, 93580, 93581) (Report only once per catheterization procedure) (Do not report for pharmacologic agent administration in conjunction with coronary interventional procedure codes , 92975, 92977) T ffective 10/14/13 Revise the parenthetical cross-reference following code to include the congenital cardiac catheterization codes and delete codes 93563,

5 rrata and Technical Corrections Category III (0256T has been deleted. To report, see 33361, 33362, 33363, 33364) (0257T has been deleted. To report, see 33365, 33366) (0258T has been deleted. To report, see 33365, 33366) (0259T has been deleted. To report, see 33365, 33367, 33368, 33369) The deleted parenthetical notes for codes 0256T, 0257T, and 0259T should not be in green text with bowties as they were deleted in

6 rrata and Technical Corrections Medium Descriptors GD intrmural US needle aspirate/biopsy esophags GD transoral biopsy single/multiple GD transoral transmural drainage pseudocyst GD intraluminal tube/catheter insertion GD intrmural needle aspir/biop altered anatomy GD injection sclerosis esophgl/gastric varices GD band ligation esophgeal/gastric varices GD dilation gastric/duodenal stricture GD percutaneous placement gastrostomy tube GD flexible foreign body removal GD insert guide wire dilator passage esophagus GD balloon dilation esophagus <30 mm diam GD flex removal lesion hot bx/bipolar cautery GD removal tumor polyp/other lesion snare tech GD flex transoral w/optical endomicroscopy GD US guided transmural injxn/fiducial marker GD transoral endoscopic mucosal resection GD transoral control bleeding any method GD deliver thermal energy sphnctr/cardia GRD GD US exam surgical alter stom duodenum/jejunum GD endoscopic stent placement w/wire& dilation GD ablate tumor polyp/lesion w/dilation& wire Revise codes , 43266, and to reflect GD not DG. 6

7 rrata and Technical Corrections Short Descriptor NASAL/OROGASTRIC W/TUB PLMT Revise short descriptor for code to reflect tube plmt. Medium Descriptor xc carotid body tumor w exc carotid artery Revise medium descriptor for code Medium Descriptor Chemodenervation 1 extremity ea addl 5/> muscles Revise to reflect 5/>. Medicine Cardiovascular Comprehensive electrophysiologic evaluation including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia including left or right atrial pacing/recording when necessary, right ventricular pacing/recording when necessary, and His bundle recording when necessary with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation (Do not report in conjunction with , , 93462, 93600, 93602, 93603, 93610, 93612, 93618, 93619, 93620, 93621, 93642, 93653, 93654) Revise transposed code included in the exclusionary parenthetical note following 93656; the correct code should be Medium Descriptor Neuropsyc tstg w/prof I&R admn by tech pr hr Revise to reflect Neuro. Category II Patient History Medium and Short Descriptor 1040F DSM-5 criteria for major depressive disorder documented at the initial evaluation (MDD, MDD ADOL) F Dsm-5 criteria mdd docd at the initial eval 1040F DSM-5 INFO MDD DOCD Revise code descriptor, medium, and short descriptor for code 1040F to reflect 5. -mail notifications Sign up to receive notification when changes are posted to the AMA Web site for CPT Announcements, Category II codes, Category III codes, Vaccine codes, rrata and Panel Agenda Proposals and Subsequent Actions. You may also receive notice when registration opens for the CPT ditorial Panel meeting. 7