Replacing ICD-9-CM with ICD-10-CM

CPT Changes -2014

E & M

Telephone / Internet consultation - 99446-99449

New CPT – Section (4 New Codes)

•  A specialist consults with a patient’s primary physician to offer opinion or advice
• Typically provided in complex and/or urgent situations where a timely face-to-face service with the consultant may not be feasible
•  Include a review of the patient’s medical records, test results, etc
•  Does not meet face-to-face with the patient.
•  Time-based services
•  Don’t report if consultant has seen the patient in F-F encounter with 14 days

  New code for Category III codes

+ 99481 - Treated for hypothermia causing systemic breakdown (total body)– Neonate

+ 99482 - Treated for hypothermia by selectively cooling the head- Neonate

Corresponding Cat III codes were deleted – 0260T & 02601T

Neurology

Chemodenervation

Neck/Extremity/Trunk muscles were extended based on no of extremity and muscles

Deleted -2 CPTs (64613/64614) – Neck and Extremity

New codes- 8  CPTs  (64616-17, 64642-64647)

Neck muscles           -     Neck muscles excluding larynx

-         Larynx with guided Needle EMG when performed

Extremity muscles   -     One extremity 1-4 muscles

-         Each additional extremity 1-4 muscles

-         One extremity 5 or more muscles

-         Each additional extremity 5 or more muscles

-         Trunk  1-5 muscles

-         Trunk  6 or more muscles

Genitourinary

New code- 1

52356 – Cystourethroscopy with pyeloscopy and lithotripsy with stent placement

Deleted code-1

50021– Drainage of perirenal or renal abscess; percutaneous

Cross walk code – New code- 49405- Drainage by catheter; visceral, percutaneous

(eg, abscess, hematoma, seroma, lymphocele, cyst)

(eg, kidney, liver, spleen, lung/mediastinum)

Auditory system

There is only one revised codes

2013: 69210 – Removal impacted cerumen (separate procedure), 1 or both ears

2014:                  Removal of impacted cerumen requiring instrumentation; Unilateral

Eye and Ocular adnexa

Revised codes- 2

2013:

65778-Placement of amniotic membrane on the ocular surface for wound healing; self-retaining

65779-Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured

2014:

For both CPT phrase “for wound healing” was removed

CPT 65778:  phrase “self retaining” was replaced with “without sutures”

 “self retaining” – refers to a process in which the membrane could sit on the eye for several days while the eye healed. 2014 CPT clarifies it occurs when no suture applied

Integumentary

  

Breast bx and Clip placement

Deleted Codes

19102/03 ( 2 Codes ) – Bx Breast – with Image guide  

New codes

Bx with clip placement; with image guidance when performed

19081-86 ( 6 New codes )

Clip placement and Imaging of bx specimen – when perfomed

Steriotactic guided Bx         First lesion

                                               Each additional lesion

Ultrasound guided Bx          First lesion

                                               Each additional lesion

MR guided Bx                      First lesion

                                               Each additional lesion

Clip placement without Bx; with image guidance when performed

19281-19288 ( 8 New codes)

Mammographic guided clip placement    First lesion

                                                                     Each additional lesion

Steriotactic guided clip placement           First lesion

                                                                     Each additional lesion

Ultrasound guided clip placement            First lesion

                                                                     Each additional lesion

MR guided clip placement                        First lesion

                                                                     Each additional lesion

Repair

Deleted – All other CPT codes for repair were almost more than 1 CM and this is the one which was left.

Usually it is done by adhesives or steri-strips

13150 - Nose/eyelids/ears/Lips – less than 1 CM  Complex repair

Revised- 15777- Implantation of biologic implant , soft tissue reinforcement

Eg breast , trunck is changed to ie breast , trunck

Medicine

Deleted code (1) 92506 - Evaluation of speech, language, voice, communication, and/or auditory processing

CPT 2014 deleted 92506 because the single code made it difficult for the AMA's Relative Update Committee (RUC) to assign professional work values that reflect the diverse types of work that go into evaluations for speech, language, fluency, and voice disorders.

And it was expanded with four new CPT with more specific professional work.

New codes -4 (92521-92524)

Evaluation of speech fluency (eg, stuttering, cluttering)

Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);

Evaluation of speech sound production; with evaluation of language comprehension and expression

Behavioral and qualitative analysis of voice and resonance

Percutaneous approach cardiac procedure

Two New CPTs

93582- Percutaneous transcatheter closure of PDA

93583- Percutaneous transcatheter septal reduction therapy with Temp pacemaker insertion when performed

                        (Shrinking a lower heart chamber defect)

Others

94669 – Mechanical chest wall oscillation to facilitate lung function

                                    (Physician may select this procedure when manipulation of chest wall (Cffing,vibiration, tapping,pounding,etc…) is not bringing out good result )

                                   

97610 – Ultrasound wound assessment (Replacement for the temp Cat III code 0183T)

Revised codes

Cardiac Ablations – Revised codes

93653 –Ablation therapy for supra ventricular tachycardia

93654 – Ablation therapy for ventricular tachycardia

There is a change the code description – RV/RA/HIS bundle recording are not required to meet the code selection & it was changed with a word “when necessary”

Anogenital exam - Child

99170- Anogenital exam with colposcopic magnification in childhood for suspected trauma

CPT 2014 added two clarifications:

1. The exam must occur, not under colposcopy

2. The code includes recording of the images when performed

Revision: Anogenital exam in childhood for suspected trauma; image recording when performed

Breath Analysis

91065- Breath hydrogen test (for detection of lactase deficiency, bacterial overgrowth,)

                       

Revised as Breath hydrogen or methane test

The bacteria produce hydrogen when they are exposed to unabsorbed food. Excessive amounts of hydrogen also may be produced in a condition called bacterial overgrowth. Bacterial overgrowth occurs when the bacteria in the colon move back into the small intestine. The bacteria are exposed to food in the small intestine that has not been fully digested and absorbed. Regardless of the condition causing the excessive production of hydrogen, the end result is the same.

Some of the hydrogen produced by the bacteria is absorbed into the blood flowing through the wall of the intestine and colon. The blood travels to the lungs where the hydrogen is released and exhaled in the breath where it can be measured.

At the start of the test, a sample breath is taken. The individual blows into and fills a balloon with a breath of air. The concentration of hydrogen from the sample breath is removed from the balloon and measured.

Musculoskeletal

Foreign Body removal – Shoulder

FB removal deep/complicated codes deleted and differentiated with foreign body and prosthetic components

Deleted codes – 2 (23331-23332)

Removal of FB shoulder deep and complicated

New codes -3 (23333-23335)

FB removal shoulder Deep

Prosthetic removal Humeral or Glenoid component

Prosthetic removal Humeral and Glenoid component

Revised codes (24 CPTs)

Radical resection of tumor soft tissue

All CPT code’s description were replaced with a word “Sarcoma” instead of “Malignant”

Sarcomas are malignant tumor originating from soft tissues such as muscles/blood vessels/ nerves/tendon…

Implant removal – Elbow (2 CPTs) 24160/24164

Implant removal       – Prosthetic removal

Elbow joint                - Humeral and ulnar components

            -Added “including debridement and synovectomy 

Respiratory system

There is only one deleted code and no revised or new codes

32201 – Pneumonostomy; with percutaneous drainage of abscess or cyst

Cross walk code – New code- 49405- Drainage by catheter; visceral, percutaneous

(eg, abscess, hematoma, seroma, lymphocele, cyst)

(eg, kidney, liver, spleen, lung/mediastinum)

Maternity care & Delivery

There is only one deleted code and no revised or new codes

58823 – Drainage percutaneous pelvic abscess; Transvaginal/rectal

Cross walk code – New code- 49407- Drainage by catheter; percutaneous; peritoneal/retroperitoneal;  transvaginal/rectal  

 (eg, abscess, hematoma, seroma, lymphocele, cyst)