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.