Saturday, January 7, 2012

5010 conversion... I've got a Webinar coming up

Hey - If you're interested, You are welcome to come see me in Person, or via Webinar... I've got a GREAT webinar coming up on January 11th regarding the conversion from 4010 to 5010.  It is geared toward those of us that are not "IT" people.  This webinar speaks to those of us that need to know the basics, and how to get our offices on track.  The conversion to 5010 is the first of many steps toward our implementation of ICD-10...  I hope to see you there!   http://www.codingcert.com/webinar-hipaa-version-5010-are-you-ready/ 

On January 12th - If ;you're in the Boise Area, you are personally invited to see me present at the AAPC Boise Chapter Meeting... I'll be speaking on the importance of Fetal Non-Stress Testing and it's clinical implications.  I'd love to see you there!!!  The info is on the AAPC site,    http://www.aapc.com/localchapters/viewcalendarevent.aspx?id=01008296&eid=27007369-6031-4684-86B1-A26458FAAAD8

If you're really wanting a good time with lots of CEU's...  I'll be presenting at the AAPC National Convention in April 1-4,  2012  from Las Vegas, NV.    I'll be back again this year with my daVinci robotics presentation, and a new one on the Mysteries of OB Ultrasound coding...  We're gonna have a rockin' good time, so I really hope to see you there!    http://www.aapc.com/medical-coding-education/conferences/national/lasvegas/index.aspx


HAPPY CODING!!!

Monday, January 2, 2012

CPT2012 - Quick list of coding changes

Hopefully this new year will bring all of you good fortune.  CPT & HCPCS have some changes in store for us...  Here's a quick list of what you should be on the look-out for.   When in doubt - always read and re-read your guidelines that CPT provides for us...   and HAPPY CODING!

Evaluation and Management
  • Clarification to the wording of prolonged service description removes the term physician and removes face to face language for inpatient codes (Medicare may still require face to face)
  • Clarification that 99356 should be used in inpatient or observation setting
  • Time component added to CPT codes 99218-99220 Initial Observation
 
New Medicare screening/counseling codes 

G0446 –Intensive Behavioral Therapy for Cardiovascular Disease
G0444- Screening for Depression in Adults
G0449- Annual Obesity Screening
G0447- Intensive Behavioral Therapy for Obesity
G0442- Annual alcohol misuse screening
G0443- Behavioral counseling for alcohol misuse

Medicare Annual Wellness visit-
Now includes requirement for Health Risk assessment

Medicare Telehealth services revised to include Emergency department & smoking cessation codes
  • G0425 Initial inpatient or emergency department telehealth consultation, typically 30 minutes communicating with the patient via telehealth
  • G0426 Initial inpatient telehealth or emergency department consultation, typically 50 minutes communicating with the patient via telehealth
  • G0427 Initial inpatient or emergency department telehealth consultation, typically 70 minutes or more communicating with the patient via telehealth
  • Smoking cessation codes 99406, 99407, G0436 and G0437 have been added to the list of covered Telehealth services

CPT Surgery Section: 


Surgery-

Integumentary- Many codes in the skin grafting and skin substitute replacement
have been deleted and replaced with new codes

  • 15170-15176 and 15300-15431 have been deleted
  • New codes 15271-15278 have been added

Musculoskeletal-
  • Two new codes have been added 22633 and 22634 to describe arthrodesis with a combined posterior and posterolateral technique and posterior interbody technique
  • New codes and revisions to 29581-29583 Application of multi-layer compression system
  • 29581-ankle and foot
  • 29582-thigh and leg
  • 29583-upper arm and forearm
  • Arthroscopy knee revision codes to 29880 and 29881 to include same or multiple compartments

Respiratory System
  • Multiple revisions and new codes including 32096, 32098, 32505, 32056, 32507 thoractomy codes and 32601-32674 for new VATS codes (video assisted thoracic surgery)

Cardiovascular System
  • Multiple revisions to the pacing and Cardioverter-Defibrillator codes 33002-33249 along with nine new codes
  • Multiple revisions to revascularization codes

Digestive System -
  • Abdominal Paracentesis codes 49080 and 49081 have been deleted and replaced with three new codes
    • 49082-abdominal paracentesis without image guidance
    • 49083- abdominal paracentesis with image guidance
    • 49084-Peritoneal lavage including image guidance

Gynecology & OB Services -
No major changes for 2012 -  but the below integumentary codes are used in OB/GYN offices and have been changed.
  • 11975 and 11977 insertions of contraceptive capsules have been deleted,
  • use 11981 to report insertion and 11976 for removal

Nervous System-
  • Destruction of paravertrebral facet joint code 64622-64627 have been deleted.  
  • Nnew codes were added to specify location:
    • 64633-64634- destruction with image guidance cervical or thoracic
    • 64635-64636- destruction with image guidance lumbar or sacral
  • Codes 64553, 64565, 64575-64585 Neurostimulator electrode codes have beenrevised to add language of "array"

Radiology Section -

Deletions:
  • Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation;
    • 73542 Radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation;
    • 75722 Angiography, renal, unilateral, selective (including flush aortogram), radiological supervision and interpretation;
    • 75724 Angiography, renal, bilateral, selective (including flush aortogram), radiological supervision and interpretation;
    • 75940 Percutaneous placement of IVC filter, radiological supervision and interpretation;

    • 77079 appendicular skeleton (peripheral) (eg, radius, wrist, heel)
    • 77083 Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites;
    • 78223 Hepatobiliary ductal system imaging, including gallbladder, with or without pharmacologic intervention, with or without quantitative measurement of gallbladder function;
    • 78584 Pulmonary perfusion imaging, particulate, with ventilation; single breath
    • 78585 Pulmonary perfusion imaging, particulate, with ventilation; rebreathing and washout, with or without single breath
    • 78586 Pulmonary ventilation imaging, aerosol; single projection
    • 78587 multiple projections (eg, anterior, posterior, lateral views)
    • 78588 Pulmonary perfusion imaging, particulate, with ventilation imaging, aerosol, 1 or multiple projections;
    • 78591 Pulmonary ventilation imaging, gaseous, single breath, single projection;
    • 78593 Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or without single breath; single projection
    • 78594 multiple projections (eg, anterior, posterior, lateral views)
    • 78596 Pulmonary quantitative differential function (ventilation/ perfusion) study;

    ADDTIONS:

    • 74174 Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing
    • 77424 Intraoperative radiation treatment delivery, x-ray, single treatment session
    • 77425 Intraoperative radiation treatment delivery, electrons, single treatment session
    • 77469 Intraoperative radiation treatment management
    • 78226 Hepatobiliary system imaging, including gallbladder when present;
    • 78227 Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed
    • 78579 Pulmonary ventilation imaging (eg, aerosol or gas)
    • 78582 Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging
    • 78597 Quantitative differential pulmonary perfusion, including imaging when performed
    • 78598 Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed
     
Radiology services "T" codes and Unlisted code additions
  • 93998 Unlisted noninvasive vascular diagnostic study
  • 0274T Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), with or without the use of an endoscope, single or multiple levels, unilateral or bilateral; cervical or thoracic
  • 0275T Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), with or without the use of an endoscope, single or multiple levels, unilateral or bilateral; lumbar
  • 0282T Percutaneous or open implantation of neurostimulator electrode array(s), subcutaneous (peripheral subcutaneous field stimulation), including imaging guidance, when performed, cervical, thoracic or lumbar; for trial, including removal at the conclusion of trial period
  • 0283T Percutaneous or open implantation of neurostimulator electrode array(s), subcutaneous (peripheral subcutaneous field stimulation), including imaging guidance, when performed, cervical, thoracic or lumbar; permanent, with implantation of a pulse generator
  • 0284T Revision or removal of pulse generator or electrodes, including imaging guidance, when performed, including addition of new electrodes, when performed
  • 0285T Electronic analysis of implanted peripheral subcutaneous field stimulation pulse generator, with reprogramming when performed

Laboratory Services-

  • Multiple new lab codes added to report genetic testing

Medicine Services Section-
  • Code 90470 administration of H1N1 vaccine has been deleted
  • Pulmonary Function test codes 94240, 94260, 94350, 94360, 94370 have been deleted
 New codes added  for the Medicine section
  • 94726-Plethysmography for determination of lung volumes and airway resistance
  • 94727 Gas dilution or washout for lung volumes and distribution of ventilation abd closing volumes
  • 94728-Airway resistance by impulse oscillometry
  • +94729-Diffusing capacity (add on code)
  • New needle electromyography  add-on codes + 95885-95887 are  to be used with nerve conduction studies

New HCPC's
  • G0450- Screening for sexually transmitted infections, includes laboratory tests for Chlamydia, Gonorrhea, Syphilis and Hepatitis B

  • New modifier-PD -Diagnostic or related non-diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days—changes to Medicare 72 hour rule go in to effect July 1st, 2012.