Angela Clements, CPC, CEMC, COSC Internal Consultant aclements@ochsner.org angelaclements0@gmail.com
Disclaimer The following information was put together based on my experience, research and expertise in the coding profession. CPT is a registered trademark of the AMA
CPT 2014 175 New Codes 47 Deleted Codes 107 Revised Codes Guideline Changes 47 New Category II Codes 21 New Category III Codes
Evaluation and Management Interprofessional telephone/internet assessment and management service provided by a consultative physician including a verbal and written report to the patient s treating/requesting physician or other qualified healthcare professional 99446 5-10 minutes (do not report less than 5 mins.) 99447 11-20 minutes 99448 21-30 minutes 99449 31 minutes or more
Evaluation and Management + 99481 Total body systemic hypothermia in a critically ill neonate per day +99482 Selective head hypothermia in a critically ill neonate per day Use in conjunction with 99291, 99292, 99468, 99469
Integumentary 10030 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous Includes moderate sedation
Integumentary 19102-19103 have been deleted 19081 Breast Bx with placement of localization device, when performed, and imaging of bx specimen, when performed, percutaneous, first lesion, including stereotactic guidance 19082 each additional lesion
Integumentary 19083 Breast Bx with placement of localization device, when performed, and imaging of bx specimen, when performed, percutaneous, first lesion, including ultrasound guidance 19084 each additional lesion
Integumentary 19085 Breast Bx with placement localization device, when performed, and imaging of bx specimen, when performed, percutaneous, first lesion, including magnetic resonance guidance 19086 each additional lesion
Integumentary 19281 Placement of breast localization device(s) percutaneous, first lesion, including mammographic guidance 19282 each additional lesion 19283 Placement of breast localization device(s) percutaneous, first lesion, including stereotactic guidance 19284 each additional lesion
Integumentary 19285 Placement of breast localization device(s) percutaneous, first lesion, including ultrasound guidance 19286 each additional lesion 19287 Placement of breast localization device(s) percutaneous, first lesion, including magnetic resonance guidance 19288 each additional lesion
Musculoskeletal 23333 Removal foreign body, shoulder; deep 23334 Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component 23335 humeral and glenoid component (eg total shoulder) CPT codes 23331 and 23332 have been deleted.
Cardiovascular (Revision) In 2014, the below codes were revised from Revision or relocation of skin pocket to Relocation of skin pocket. A pocket revision is not separately reportable. 33222 Relocation of skin pocket for pacemaker 33223 Relocation of skin pocket for cardio-defibrillator
Cardiovascular 33366 Transcatheter aortic valve replacement with prosthetic valve; transaortic exposure (eg left thoracotomy) Replaces 0318T Patients with severe asymptomatic aortic stenosis who are not candidates for open chest surgery
Cardiovascular Fenestrated Endovascular Repair of the Visceral and Infrarenal Aorta includes Introduction of guidewire and catheters Angioplasty of target zone Fluoroscopic guidance Diagnostic angiography of aorta and branches Intraprocedural arterial angiography
Cardiovascular 34841 Endovascular repair of visceral aorta by deployment of a fenestrated visceral aortic endograft and ; including one visceral artery endoprosthesis 34842 including two visceral artery enodoprostheses 34843 including three visceral artery endoprostheses 34844 including four or more
Cardiovascular 34845 Endovascular repair of visceral aorta and infrarenal abdominal aorta with a fenestrated visceral aortic endograft and concomitant unibody or ; including one visceral artery endoprosthesis 34846 including two visceral artery enodoprostheses 34847 including three visceral artery endoprostheses 34848 including four or more
Cardiovascular 37217 Stent intrathoracic common carotid or innominate artery by retrograde, via open 37236 Stent, open or percutaneous; initial artery 37237 each additional artery 37238 Stent, open or percutaneous; initial vein 37239 each additional vein
Cardiovascular 37241 Vascular embolization or occlusion, inclusive of all radiological S&I, intraprocedural roadmapping and imaging guidance necessary to complete the intervention; venous, other than hemorrhage
Cardiovascular 37242 arterial, other than hemorrhage or tumor 37243 for tumor organ ischemia or infarction 37244 for arterial or venous hemorrhage or lymphatic extravasation
Digestive 49405 Image-guided fluid collection drainage by catheter; visceral percutaneous 49406 ; peritoneal or retroperitoneal, percuatneous 49407 peritoneal or retroperitoneal, transvaginal or transrectal
Urinary 52356 Cystourethroscopy with lithotripsy including insertion of indwelling ureteral stent
Nervous 64616 Chemodenervation of muscles; neck muscle(s), excluding muscles of the larynx unilateral (eg, for cervical dystonia, spasmodic torticollis) Append modifier 50 for bilateral procedure Code 95873 or 95874 when guided by needle electromyography or muscle electrical stimulation. Only report one guidance 64617 Chemodenervation of muscles; larynx, unilateral, percutaneous (eg for spasmodic dysphonia), includes guidance by needle electromyography, when performed Append modifier 50 for bilateral procedure Do NOT report guidance of needle 95873 or 95874 in addition
Nervous 64642 Chemodenervation of one extremity; 1-4 muscle(s) Do NOT append modifier 50 (+) 64643 each additional extremity; 1-4 muscle(s) Code in addition to 64642 or 64644 Do NOT append modifier 50
Nervous 64644 Chemodenervation of one extremity; 5 or more muscle(s) Do NOT append modifier 50 (+) 64645 each additional extremity, 5 or more muscle(s) Code in addition to 64644 Do NOT append modifier 50
Nervous 64646 Chemodenervation of trunk muscle(s); 1-5 muscle(s) Report once per session Do NOT append modifier 50 64647 6 or more muscle(s) Report once per session Do NOT append modifier 50
Eye 66183 Insertion of anterior segment aqueous drainage device, without extrocular reservoir, external approach
Auditory 69210 Removal impacted cerumen requiring instrumentation, unilateral
Radiology + 77293 Respiratory motion management simulation Use in conjunction with 77295, 77301
Pathology and Laboratory Drug assay codes 80155 Caffeine 80159 Clozapine 80169 Everolimus 80171 Gabapentin 80175 Lamotrigine 80177 Levetiracetam 80180 Micophenolate 80183 Oxcarbazepine 80199 Tiagabine 80203 Zonisamide
Pathology and Laboratory 81287 MGMT, methylation analysis 81504 Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores 81507 Fetal aneuploidy (trisomy 21, 187 and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy + 88343 each additional separately identifiable antibody per slide
Medicine 90673 Influenza, trivalent 90685 Influenza, quadrivalent, split, preservative free; ages 6-35 months 90686 Influenza, quadrivalent, split, preservative free; ages 3 and older 90687 Influenza, quadrivalent, split, ages 6-35 months 90688 Influenza, quadrivalent, split, ages 3 and older
Medicine 92521 Evaluation of speech fluency (eg, stuttering, cluttering) 92522 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); 92523 Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language) 92524 Behavioral and qualitative analysis of voice and resonance http://www.asha.org/practice/reimbursement/coding/new-cpt-evaluation-codes-for- SLPs/
Medicine 93582 Percutaneous transcatheter closure of patent ductus arteriosus 93583 Percutaneous transcatheter septal reduction therapy including temporary pacemaker insertion when performed
Medicine 94669 Mechanical chest wall oscillation to facilitate lung function, per session 97610 Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment and instruction(s) for ongoing care, per day
Category II 37 New Codes 1 Revision
Category III 12 deleted 21 addition
Category III 0319T- 0328T Subcutaneous Implantable Defibrillator System 0329T-0339T
Next? Make sure you are using a 2014 CPT code book Paper/electronic superbills have they been updated? Staff education
Conclusion A summary of code additions, deletions and revisions can be found in Appendix B of the CPT book.
Thank you! Angela Clements, CPC, CEMC, COSC Internal Consultant aclements@ochsner.org angelaclements0@gmail.com