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2012 CPT Coding Changes – Part II Quick Look Summary: Additional 2012 Changes for: o Complete L-‐S spine x-‐rays, including bending views o L-‐S spine x-‐rays, bending views only o Vertebroplasty o Conscious Sedation bundling into Liver and Lung Biopsies, as well as Catheter placements into the aorta and abdominal, pelvic, or lower extremity artery branches In addition to the new bundling CPT coding changes that are effective in January that were previously outlined, (CTA Abdomen and Pelvis bundling, Nuc Med changes for HIDA scans and Pulmonary imaging codes, as well as the renal angiography and IVC filter changes), there were a few more instructional changes in CPT for 2012 that pertain to the Radiology book of business. Though the actual CPT code for the “Complete” L-‐S spine x-‐ray, including bending views has not changed the requirements for assigning CPT code 72114 has. In 2012, there must be a minimum of 6 views imaged to allow assigning this code. If bending views are the only views imaged, in 2012 coders no longer need 4 views documented as the AMA/CPT has reduced the required number of views to 2 or 3 views to properly assign CPT code 72120. Specifying the actual views being interpreted (AP, Lateral, flexion, extension, LPO, RPO, left and right bending views, etc.) better assists the coder when assigning codes from the spine x-‐ray section of CPT. The guidelines for assigning codes 72100 (L-‐S spine, 2 or 3 views) and 72110 (L-‐S spine, minimum of 4 views) have not changed. The AMA has also changed the reporting rules for Vertebroplasty procedures to no longer allow separate reporting of bone biopsies when performed at the same level as the Vertebroplasty. (Bone biopsies have never been separately reportable with Kyphoplasty procedures.) Remember, if the physician performs a bone biopsy at a level not addressed by the Vertebroplasty, the coder may report the biopsy separately by appending a -‐59 modifier. Other changes that will affect reimbursement in 2012 include the determination that conscious sedation is inherent in both the Liver biopsy (47000) and Lung biopsy (32405) codes. Conscious sedation was also included in the non-‐selective catheter insertion into the aorta (36200) and selective catheter insertions into the abdominal, pelvic, or lower extremity arterial branches (36200, 36245, 36246, 36247 & 36248) for 2012. Bundling edits will no longer allow separate reporting of CPT codes 99144 and 99145 with these procedures. This change has a potential average loss of $40 for the first 30 minutes and $25 for each subsequent 15 minutes that conscious sedation is utilized. Tgalan -‐ 1 -‐ 2012 Coding Changes, Part II HIS South – Radiology Division December 14, 2011