Saturday, January 6, 2018

2018 changes in CPT codes

CODES NOT TO BE USED AFTER 12/31/17:

Anesthesia: 00740 00810 01180 01190 01682    

Drugs/Vaccines: J1725 Q9984  

Medicine: 93982 94620  

Radiology: 71040 71015 71020 71021 71022 71023 71030 71034 71035 74000 74010 74020 75658 75952 75953 75954 77422 78190 G0202 G0204 G0206   

Surgery: 15732 29582  29583  31320  34800  34802  34803 34804 34805 34806 34825 34826 34900 36120 36515 55450 64565 69820 69840 

NEW CPT CODES EFFECTIVE 1/1/2018:

Drugs/Vaccines:

Description 90756 Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5ml dosage, for intramuscular use

J1726 Injection, hydroxyprogesterone caproate, (makena), 10 mg 

J1729 Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg 

J2326 Injection, nusinersen, 0.1 mg (Spinraza)

J7296 Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg

Q5101 Injection, filgrastim (g-csf), biosimilar, 1 microgram

Q5102 Injection, infliximab, biosimilar, 10 mg

Anesthesia

00731 Anesthesia for upper gastrointestinal endoscopic procedures,
endoscope introduced proximal to duodenum;not otherwise
specified

00732 Endoscopic retrograde cholangiopancreatography (ercp)

00811 Anesthesia for lower intestinal endoscopic procedures, endoscope
introduced distal to duodenum; not otherwise specified

00812 Screening colonoscopy

00813 Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum

Medicine

94617 Exercise test for bronchospasm, including pre- and post-spirometry,
electrocardiographic recording(s), and pulse oximetry

94618 Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry,and oxygen titration, when performed

96573 Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application
and illumination/activation of photosensitizing drug(s) provided by a
physician or other qualified health care professional, per day

96574
Debridement of premalignant hyperkeratotic lesion(s) (ie,targeted
curettage, abrasion) followed with photodynamic therapy by external
application of light to destroy premalignant lesions of the skin and
adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day

Radiology

71045 Radiologic examination, chest; single view

71046 2 views

71047 3 views

71048 4 or more views

74018 Radiologic examination, abdomen; 1 view

74019 2 views

74021 3 or more views

74261 Diagnostic CT scan of large bowel

74262 Diagnostic CT scan of large bowel with contrast dye

Surgery

15730 Creation of flap graft to midface

15733 Creation of flap graft to head and/or neck

19294 Preparation of tumor cavity and placement of radiation therapy applicator into breast for radiation therapy concurrent with partial breast removal

20939 Harvest of bone marrow for spine surgery graft

31241 Tying of sphenopalatine artery using an endoscope

31253 Complete examination of nose and sinuses using an endoscope

31257 Complete examination of nose and sinuses and removal of nasal sinus using an endoscope

31259 Removal of tissue from sphenoid sinus using an endoscope

31298 Dilation of nasal sinus using an endoscope

34701 Placement of graft for repair of aorta including radiological supervision and interpretation

34702 Placement of graft for repair of aorta including radiological supervision and interpretation

34703 Placement of graft for repair of aorta and groin artery including radiological supervision and interpretation

34704 Placement of graft for repair of aorta and groin artery including
radiological supervision and interpretation

34705 Placement of graft for repair of aorta and groin arteries including
radiological supervision and interpretation

34706 Placement of graft for repair of aorta and groin arteries including
radiological supervision and interpretation

34707 Placement of graft for repair of groin artery including radiological
supervision and interpretation

34708 Placement of graft for repair of groin artery including radiological
supervision and interpretation

34709 Insertion of prosthesis for repair of abdominal or groin artery including radiological supervision and interpretation
34710 Delayed insertion of prosthesis for repair of abdominal or groin artery

34711 Delayed insertion of prosthesis for repair of abdominal or groin artery

34712 Delivery of fixation device to graft via catheter including radiological supervision and interpretation

34713 Exposure of one groin artery for delivery of graft, accessed through the skin

34714 Exposure of one groin artery with creation of conduit, open procedure

37415 Exposure of one underarm or upper chest artery for delivery of prosthesis, open procedure

37416 Exposure of one underarm or upper chest artery with creation of conduit

38222 Bone marrow biopsy and aspiration

38573 Removal of all lymph nodes of both sides of pelvis using an endoscope

Thursday, September 7, 2017

93010 denied for Duplicate service

Maximum 5 units of 93010 can be billed per date of service. 

If duplicate 93010 is performed on same day by same Physician then use modifier 76

And if duplicate service is performed on same day by different Physician then use Modifier 77

Sunday, March 26, 2017

How to code Annual wellness visit for Medicare and commercial insurance

For Medicare, annual wellness visits will be paid with following codes

G0402:  Initial Preventive Physical Examination; face-to-face visit, services limited to a new patient during the first 12 months of Medicare enrollment. (welcome to Medicare; one time benefit)

G0438: Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

G0439: Annual wellness visit; includes a personalized prevention plan of service (pps), subsequent visit


For Commercial insurance, use 99381---99397

Thursday, March 23, 2017

New billing guidelines for Prolonged services 99358, 99359

Prolonged services 2017 guidelines



CPT codes 99358 and 99359 (prolonged services without face-to-face contact) will be separately payable by Jan 1st, 2017 and they will not be included for payment under the related face-to-face Evaluation and Management (E/M) service code.


Additional Information

https://www. cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3678CP.pdf.

Fluoroscopic guidance codes 77002, 77003

2017 Revision of Fluoroscopic guidance codes 77002, 77003



77002 needle placement (eg, biopsy, aspiration, injection, localization device) and 77003 (spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) will be included in global surgery period by Jan 1st, 2017 and will not be used as stand alone codes.

Replacement of code G0389 Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)

As of Jan 1st, 2017, Medicare will not accept CPT code G0389 Ultrasound Screening for Abdominal Aortic Aneurysm (AAA).


G0389 has been replaced with CPT 76706 Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)


Reference:

https://www.cms.gov/RegulationsandGuidance/Guidance/Transmittals/Downloads/R3669CP.pdf.