Shellie Sulzberger, LPN, CPC, ICDCT-CM. Tracy Bird, FACMPE, CPC, CPMA, CEMC

Transcription

1 Shellie Sulzberger, LPN, CPC, ICDCT-CM Tracy Bird, FACMPE, CPC, CPMA, CEMC

2 Reasonable efforts have been made to provide the most accurate and current information on coding and documentation changes. However codes, guidelines, and policies are subject to change and interpretation. No guarantee is given that this presentation is free of errors, omissions, misuse, or misinterpretation and this presentation should not be considered a legal or authoritative opinion. This presentation does not replace coding manuals or other authoritative resources. Current Procedural Terminology (CPT ) copyright 2017 American Medical Association. 2

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4 20939 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure) Modifier 50 for bilateral procedures Use with 22319, 22532, 22533, 22534, 22551, 22552, 22554, 22556, 22558, 22590, 22610, 22612, 22630, 22633, 22634, 22800, 22802, 22804, 22808, 22810, 22812) 4

5 Diagnostic only Revised Codes Diagnostic bone marrow; aspiration(s) biopsy(ies) New Code biopsy(ies) and aspiration(s) 5

6 Codes are only for diagnostic test purposes and is only for aspiration to obtain material for bone grafting of the spine. Any other bone marrow aspiration for therapeutic purposes would have to be reported with code because no other codes describe aspiration for therapeutic purposes. Bone marrow aspiration[s] for platelet-rich stem cell injection, use 0232T 6

7 Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed Application of multi-layer compression system; upper arm and forearm There is not a crosswalk for these code they were deleted due to low utilization 7

8 A definition for partial vertebral corpectomy has been added to the anterior or anterolateral approach for extradural exploration /decompression guidelines in the Spine and Spinal Cord section For vertebral, the term partial is used to describe removal of a substantial portion of the body of the vertebra. In the cervical spine, the amount of bone removed is defined as at least one-half of the vertebral body. In the thoracica nd lumbar spine, the amount of bone removed is defined as at least one-third of the vertebral body. 8

9 Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time Ultrasound, complete joint (i.e., joint space and peri-articular soft-tissue structures), real-time with image documentation Ultrasound, limited, joint or other nonvascular extremity structure(s) (e.g., joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation 9

10 Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes 10

11 Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes Do not report with 97760,

12 Checkout for orthotic/prosthetic use, established patient, each 15 minutes AMA crosswalks to

13 0309T Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft, when performed, lumbar, L4-L5 interspace (List separately in addition to code for primary procedure) Report above with 22899, unlisted procedure, spine 13

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15 7th character D is to be used for encounters after the patient has completed active treatment for the fracture and is receiving routine care for the fracture during the healing or recovery phase. The other 7th characters, listed under each subcategory in the Tabular List, are to be used for subsequent encounters for treatment of problems associated with the healing, such as malunions, nonunions, and sequelae. 15

16 M Spinal stenosis, lumbar region without neurogenic claudication M Spinal stenosis, lumbar region with neurogenic claudication 16

17 S through S Displaced fracture of middle phalanx of S through S Nondisplaced fracture of middle phalanx of S through S Fracture of middle phalanx of lesser toe(s) Terminology corrected no other change 17

18 Deleted S through S Subluxation and dislocation of proximal interphalangeal joint of thumb S through S Subluxation and dislocation of distal interphalangeal joint of thumb Revised, not unspecified S Subluxation and dislocation of unspecified interphalangeal joint of thumb Revise to S Subluxation and dislocation of interphalangeal joint of thumb 18

19 Revise from S Other anterior dislocation of hip Revise to S Other anterior subluxation and dislocation of hip Revise from S Central dislocation of hip Revise to S Central subluxation and dislocation of hip 19

20 S72 Fracture of femur, S82 Fracture of lower leg, Excludes2: Revise from periprosthetic fracture of prosthetic implant of (T84.-) Revise to periprosthetic fracture of prosthetic implant of (M97.-) T84.01 Broken internal joint prosthesis Excludes1: Revise from periprosthetic joint implant fracture (T84.04) Revise to periprosthetic joint 20

21 T07 Unspecified multiple injuries T07.XXXA unspecified multiple injuries, initial encounter T07.XXXD - unspecified multiple injuries, subsequent encounter T07.XXXS - unspecified multiple injuries, sequela T14.8 Other injury of unspecified body region T14.8XXA other injury of unspecified body region, initial encounter T14.8XXD - other injury of unspecified body region, subsequent encounter T14.8XXS - other injury of unspecified body region, sequela 21

22 T14.9 Injury unspecified T14.9XXA injury unspecified, initial encounter T14.9XXD injury unspecified, subsequent encounter T14.9XXS injury unspecified, sequela 22

23 Z71.82 Exercise counseling May be used in conjunction with recommendation for exercise program incorporating balance, gait, and strength training in patients at risk for falls 23

24 Repository/uuid/dDocName: ers.nsf/files/drug_therapy_requiring_intensive _Monitoring_for_Toxicity.pdf/$FIle/Drug_Thera py_requiring_intensive_monitoring_for_toxicity.pdf ources/provider_types/2009_0608_evalmngmn tqamdm.shtml 24

25 CCI assists our clients improve their documentation quality, coding and billing accuracy, and compliance with health care regulations TSP Healthcare assists our clients with strategic planning, LEAN / process improvement, compliance effectiveness, and compensation / benefit analysis 25

26 Shellie Sulzberger, LPN, CPC, ICDCT-CM Tracy Bird, FACMPE, CPC, CEMC, CPMA 26