2013 CPT Coding Update!
 

2013 CPT Coding Update!

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    2013 CPT Coding Update! 2013 CPT Coding Update! Presentation Transcript

    • 2013 CPTCODINGUPDATE!CPT® is a registeredtrademark of the AmericanMedical Association.
    • CPT® 2013 code changes announced; new codes reflect care advancements Allowphysicians to report advancements in healthcare services  Molecular Tests  Care Coordination  SINGLE LARGEST EXPANSION  186 New Codes Added  119 Outdated Codes Deleted  263 Another Revised Codes
    • SINGLE LARGEST EXPANSION Result of:  Significant advancements in medical understanding and testing for Molecular Disease  Including Human Genome Project  The 2013 codes include 116 for molecular pathology!
    • New Codes Will Enhance.. Reporting of innovative diagnostic tools Improve Health Outcomes Reduce Long-Term Care Cost Additional Updates  Reflect Practice Changes and Improvements in  Cardiology  Neurologic Testing  Psychiatry
    • "Medical knowledge is constantlyadvancing, and as steward of CPT, theAMA invests extensive resources each yearto keep the code set current withcontemporary medical science andtechnology," AMA President Jeremy A.Lazarus, MD
    • When is the code set updated? The code set is updated annually with direct input from the health care community:  Practicing Physicians  Allied Health Professionals  Advisors from more than 100 medical specialty societies  Such input has allowed the code set to better support the reporting needs of physicians and other professionals in emerging models of care, including patient-centered medical homes and accountable care organizations.
    • Click here for the 2013 CPTcode changes "Tapping into the clinical expertise of the health care community produces the practical enhancements that CPT needs to reflect the coding demands of the modern health care system," Dr. Lazarus said.
    • A few CPT 2013 CPT codes.. Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy,with posterior instrumentation, with image guidance, includes bone graft, when performed,lumbar, L4-L5 interspace (List separately in addition to code for primary0309T procedure Motor function mapping using non-invasive navigated transcranial magnetic stimulation(nTMS) for therapeutic treatment planning,0310T upper and lower extremity Non-invasive calculation and analysis of central arterial pressure0311T waveforms withinterpretation and report Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction(EGJ),0312T with implantation of pulse generator, includes programming Vagus nerve blocking therapy (morbid obesity); laparoscopic revision or replacement of vagaltrunk neurostimulator electrode0313T array, including connection to existing pulse generator
    • Vagus nerve blocking therapy (morbid obesity); laparoscopic removal of vagal trunkneurostimulator electrode array and pulse0314T generator Vagus nerve blocking therapy (morbid obesity); removal of pulse generator agus nerve blocking therapy (morbid obesity); removal of0315T pulse generator Vagus nerve blocking therapy (morbid obesity); replacement of0316T pulse generator Vagus nerve blocking therapy (morbid obesity); neurostimulator pulse generator electronicanalysis, includes reprogramming when performed0317T Implantation of catheter-delivered prosthetic aortic heart valve,0318T open thoracic approach, (eg,transapical, other than transaortic)
    • Implantation of catheter-delivered prosthetic aortic heart valve,0319T open thoracic approach, (eg,transapical, other than transaortic0320T Insertion of subcutaneous defibrillator electrode Insertion of subcutaneous implantable defibrillator pulse generator0321T only with existingsubcutaneous electrode Removal of subcutaneous implantable defibrillator pulse generator0322T only Removal of subcutaneous implantable defibrillator pulse generator with replacement of subcutaneous implantable defibrillator pulse0323T generator only
    • 0324T Removal of subcutaneous defibrillator electrode Repositioning of subcutaneous implantable defibrillator electrode0325T and/or pulse generator Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillationthreshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmiatermination, and programming or reprogramming of sensing or therapeutic0326T parameters Interrogation device evaluation (in person) with analysis, review and report, includesconnection, recording and disconnection per patient encounter; implantable subcutaneouslead defibrillator0327T system Programming device evaluation (in person) with iterative adjustment of the implantable deviceto test the function of the device and select optimal permanent programmed values0328T withanalysis; implantable subcutaneous lead defibrillator system
    • 0580F Multidisciplinary care plan developed or updated (DSP) Patient transferred directly from anesthetizing location to critical care0581F unit (Peri2) Patient not transferred directly from anesthetizing location to critical0582F care unit (Peri2)0583F Transfer of care checklist used (Peri2)0584F Transfer of care checklist not used (Peri2)
    • Did we say a few? Symptoms and signs of distal symmetric polyneuropathy reviewed1500F and documented (DSP)1501F Not initial evaluation for condition (DSP Patient queried about pain and pain interference with function1502F using a valid and reliableinstrument (DSP1503F Patient queried about symptoms of respiratory insufficiency (DSP)1504F Patient has respiratory insufficiency (DSP
    • Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy,with posterior instrumentation, with image22586 guidance, includes bone graft when performed, L5-S1 interspace Revision of total shoulder arthroplasty, including allograft when23473 performed; humeral or glenoidcomponent Revision of total shoulder arthroplasty, including allograft when23474 performed; humeral andglenoid component Revision of total elbow arthroplasty, including allograft when24370 performed; humeral or ulnar component Revision of total elbow arthroplasty, including allograft when24371 performed; humeral and ulnar component
    • Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloonocclusion, when performed, assessment of air leak, airway sizing, and31647 insertion of bronchialvalve(s), initial lobe Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withremoval of bronchial31648 valve(s), initial lobe Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withremoval of bronchial valve(s), each additional lobe (List separately in addition to31649 code for primary procedure) Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloonocclusion, when performed, assessment of air leak, airway sizing, and insertion of bronchialvalve(s), each additional lobe (List31651 separately in addition to code for primary procedure[s] Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; withbronchial thermoplasty, 131660 lobe
    • Bronchoscopy, rigid or flexible, including fluoroscopic31661 guidance, when performed; withbronchial thermoplasty, 2 or more lobes Thoracentesis, needle or catheter, aspiration of32554 the pleural space; without imaging guidance Thoracentesis, needle or catheter, aspiration of32555 the pleural space; with imaging guidance Pleural drainage, percutaneous, with insertion of32556 indwelling catheter; without imagingguidance Pleural drainage, percutaneous, with insertion of32557 indwelling catheter; with imaging guidance
    • Thoracic target(s) delineation for stereotactic body32701 radiation therapy (SRS/SBRT), (photon or particle beam), entire course of treatment Transcatheter aortic valve replacement (TAVR/TAVI) with33361 prosthetic valve; percutaneousfemoral artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with33362 prosthetic valve; open femoralartery approach Transcatheter aortic valve replacement (TAVR/TAVI) with33363 prosthetic valve; open axillaryartery approach Transcatheter aortic valve replacement (TAVR/TAVI) with33364 prosthetic valve; open iliac arteryapproach
    • Transcatheter aortic valve replacement (TAVR/TAVI) with33365 prosthetic valve; transaorticapproach (eg, median sternotomy, mediastinotomy) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonarybypass support with33367 percutaneous peripheral arterial and venous cannulation (eg, femoralvessels) (List separately in addition to code for primary procedure) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonarybypass support with33368 open peripheral arterial and venous cannulation (eg, femoral, iliac,axillary vessels) (List separately in addition to code for primary procedure) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonarybypass support with33369 central arterial and venous cannulation (eg, aorta, right atrium,pulmonary artery) (List separately in addition to code for primary procedure) Insertion of ventricular assist device, percutaneous33990 including radiological supervision andinterpretation; arterial access only Insertion of ventricular assist device, percutaneous33991 including radiological supervision andinterpretation; both arterial and venous access, with transseptal puncture
    • Removal of percutaneous ventricular assist device at33992 separate and distinct session frominsertion Repositioning of percutaneous ventricular assist device33993 with imaging guidance at separateand distinct session from insertion Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid,vertebral, and/or intracranial vessels, unilateral or bilateral, and all36221 associated radiologicalsupervision and interpretation, includes angiography of the cervicocerebral arch, whenperformed Selective catheter placement, common carotid or innominate artery, unilateral, any approach,with angiography of the ipsilateral extracranial carotid36222 circulation and all associatedradiological supervision and interpretation, includes angiography of the cervicocerebral arch,when performed Selective catheter placement, common carotid or innominate artery, unilateral, any approach,with angiography of the ipsilateral intracranial carotid36223 circulation and all associatedradiological supervision and interpretation, includes angiography of the extracranial carotidand cervicocerebral arch, when performed
    • Selective catheter placement, internal carotid artery, unilateral, with angiography of theipsilateral intracranial carotid circulation and all associated radiological36224 supervision andinterpretation, includes angiography of the extracranial carotid and cervicocerebral arch,when performed Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral36225 vertebral circulation and all associated radiological supervision andinterpretation, includes angiography of the cervicocerebral arch, when performed Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateralvertebral circulation and36226 all associated radiological supervision and interpretation, includesangiography of the cervicocerebral arch, when performed Selective catheter placement, external carotid artery, unilateral, with angiography of theipsilateral external carotid36227 circulation and all associated radiological supervision andinterpretation (List separately in addition to code for primary procedure) Selective catheter placement, each intracranial branch of the internal carotid or vertebralarteries, unilateral, with angiography of the selected vessel circulation and all36228 associatedradiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (List separately in addition to code for primary procedure)
    • Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter),37197 includes radiological supervision and interpretation, and imaging guidance(ultrasound or fluoroscopy), when performed Transcatheter therapy, arterial infusion for thrombolysis37211 other than coronary, any method,including radiological supervision and interpretation, initial treatment day Transcatheter therapy, venous infusion for thrombolysis, any37212 method, including radiologicalsupervision and interpretation, initial treatment day Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, anymethod, including radiological supervision and interpretation, continued37213 treatment onsubsequent day during course of thrombolytic therapy, including follow-up catheter contrastinjection, position change, or exchange, when performed; Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, anymethod, including radiological supervision and interpretation, continued treatment onsubsequent day during course of thrombolytic37214 therapy, including follow-up catheter contrastinjection, position change, or exchange, when performed; cessation of thrombolysis includingremoval of catheter and vessel closure by any method
    • Electrodiagnostic studies for distal symmetric polyneuropathy not conducted (or3752F requested),documented, or reviewed within 6 months of initial evaluation for condition (DSP) Patient has clear clinical symptoms and signs that are highly suggestive of neuropathy ANDcannot be3753F attributed to another condition, AND has an obvious cause for the neuropathy(DSP) Screening tests for diabetes mellitus reviewed, requested,3754F or ordered (DSP) Cognitive and behavioral impairment screening3755F performed (DSP) Patient has pseudobulbar affect, sialorrhea, or3756F ALS related symptoms (DSP) Patient does not have pseudobulbar affect, sialorrhea, or3757F ALS related symptoms (DSP) Patient referred for pulmonary function testing or peak3758F cough expiratory flow (DSP)
    • Take effect January 1, 2013.. Patient screened for dysphagia, weight loss, and3759F impaired nutrition, and results documented(DSP) Patient exhibits dysphagia, weight loss, or impaired3760F nutrition (DSP) Patient does not exhibit dysphagia, weight loss, or3761F impaired nutrition (DSP)3762F Patient is dysarthric (DSP)3763F Patient is not dysarthric (DSP)38243 Hematopoietic progenitor cell (HPC); HPC boost Esophagoscopy, rigid or flexible; with optical43206 endomicroscopy
    • Upper gastrointestinal endoscopy including esophagus,43252 stomach, and either the duodenumand/or jejunum as appropriate; with optical endomicroscopy Preparation of fecal microbiota for instillation,44705 including assessment of donor specimen4540F Disease modifying pharmacotherapy discussed (DSP) Patient offered treatment for pseudobulbar affect,4541F sialorrhea, or ALS related symptoms (DSP) Options for noninvasive respiratory support discussed with4550F patient (DSP)4551F Nutritional support offered (DSP) Patient offered referral to a speech language pathologist4552F (DSP)
    • Patient offered assistance in planning for end of life issues4553F (DSP)4554F Patient received inhalational anesthetic agent (Peri2) Patient did not receive inhalational anesthetic4555F agent (Peri2) Patient exhibits 3 or more risk factors for post-operative4556F nausea and vomiting (Peri2) Patient does not exhibit 3 or more risk factors for post-4557F operative nausea and vomiting (Peri2) Patient received at least 2 prophylactic pharmacologic4558F anti-emetic agents of different classespreoperatively and intraoperatively (Peri2) At least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees4559F Fahrenheit) recorded within the 30 minutes immediately before or the 15minutes immediately after anesthesia end time (Peri2)
    • Anesthesia technique did not involve general or neuraxial4560F anesthesia (Peri2)4561F Patient has a coronary artery stent (Peri2)4562F Patient does not have a coronary artery stent (Peri2) Patient received aspirin within 24 hours prior to anesthesia4563F start time (Peri2) Cystourethroscopy, with injection(s) for chemodenervation52287 of the bladder Chemodenervation of muscle(s); muscle(s) innervated by64615 facial, trigeminal, cervical spinaland accessory nerves, bilateral (eg, for chronic migraine) Thyroid uptake, single or multiple quantitative78012 measurement(s) (including stimulation,suppression, or discharge, when performed)
    • Thyroid imaging (including vascular flow, when78013 performed); Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s)quantitative78014 measurement(s) (including stimulation, suppression, or c discharge, whenperformed) Parathyroid planar imaging (including subtraction, when78071 performed); with tomographic(SPECT) Parathyroid planar imaging (including subtraction, when performed); with tomographic(SPECT), and concurrently78072 acquired computed tomography (CT) for anatomical localization DMD (dystrophin) (eg, Duchenne/Becker muscular81161 dystrophy) deletion analysis, andduplication analysis, if performed APC (adenomatous polyposis coli) (eg, familial81201 adenomatosis polyposis [FAP], attenuatedFAP) gene analysis; full gene sequence
    • APC (adenomatous polyposis coli) (eg, familial81202 adenomatosis polyposis [FAP], attenuatedFAP) gene analysis; known familial variants APC (adenomatous polyposis coli) (eg, familial81203 adenomatosis polyposis [FAP], attenuatedFAP) gene analysis; duplication/deletion variants EGFR (epidermal growth factor receptor) (eg, non- small cell lung cancer) gene analysis,common variants81235 (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q) GJB2 (gap junction protein, beta 2, 26kDa; connexin 26)81252 (eg, nonsyndromic hearing loss)gene analysis; full gene sequence GJB2 (gap junction protein, beta 2, 26kDa; connexin 26)81253 (eg, nonsyndromic hearing loss)gene analysis; known familial variants
    • GJB6 (gap junction protein, beta 6, 30kDa, connexin 30) (eg, nonsyndromic hearing loss)gene analysis, common81254 variants (eg, 309kb [del(GJB6-D13S1830)] and 232kb [del(GJB6-D13S1854)]) PTEN (phosphatase and tensin homolog) (eg,81321 Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis PTEN (phosphatase and tensin homolog) (eg,81322 Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant PTEN (phosphatase and tensin homolog) (eg,81323 Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-81324 Tooth, hereditary neuropathy withliability to pressure palsies) gene analysis; duplication/deletion analysis
    • PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-81325 Tooth, hereditary neuropathy withliability to pressure palsies) gene analysis; full sequence analysis PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-81326 Tooth, hereditary neuropathy withliability to pressure palsies) gene analysis; known familial variant81479 Unlisted molecular pathology procedure Oncology (ovarian), biochemical assays of two proteins81500 (CA-125 and HE4), utilizing serum,with menopausal status, algorithm reported as a risk score Oncology (ovarian), biochemical assays of five proteins (CA-125, apolipoprotein A1, beta-2microglobulin,81503 transferrin and pre-albumin), utilizing serum, algorithm reported as a risk score Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c,insulin, hs-CRP,81506 adiponectin, ferritin, interleukin 2-receptor alpha), utilizing serum or plasma,algorithm reporting a risk score
    • Fetal congenital abnormalities, biochemical assays of two81508 proteins (PAPP-A, hCG [anyform]), utilizing maternal serum, algorithm reported as a risk score Fetal congenital abnormalities, biochemical assays of81509 three proteins (PAPP-A, hCG [anyform], DIA), utilizing maternal serum, algorithm reported as a risk score Fetal congenital abnormalities, biochemical assays of81510 three analytes (AFP, uE3, hCG [anyform]), utilizing maternal serum, algorithm reported as a risk score Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG [anyform], DIA) utilizing maternal81511 serum, algorithm reported as a risk score (may includeadditional results from previous biochemical testing) Fetal congenital abnormalities, biochemical assays of five analytes (AFP, uE3, total hCG,hyperglycosylated hCG,81512 DIA) utilizing maternal serum, algorithm reported as a risk score81599 Unlisted multianalyte assay with algorithmic analysis
    • 82777 Galectin-3 Cell enumeration using immunologic selection and86152 identification in fluid specimen (eg,circulating tumor cells in blood); Cell enumeration using immunologic selection and86153 identification in fluid specimen (eg,circulating tumor cells in blood); physician interpretation and report, when required86711 Antibody; JC (John Cunningham) virus Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry);86828 qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and Class II HLA antigens Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry);86829 qualitative assessment of the presence or absence of antibody(ies) to HLA Class I or Class II HLA antigens
    • Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry);86830 antibody identification by qualitative panel using completeHLA phenotypes, HLA Class I Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry);86831 antibody identification by qualitative panel using completeHLA phenotypes, HLA Class II Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry);86832 high definition qualitative panel for identification of antibodyspecificities (eg, individual antigen per bead methodology), HLA Class I Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry);86833 high definition qualitative panel for identification of antibodyspecificities (eg, individual antigen per bead methodology), HLA Class II Antibody to human leukocyte antigens (HLA), solid phase86834 assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class I
    • Antibody to human leukocyte antigens (HLA), solid phase assays (eg,86835 microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus,87631 parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex reverse transcription and amplified probe technique, multipletypes or subtypes, 3-5 targets Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus,87632 parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex reverse transcription and amplified probe technique, multipletypes or subtypes, 6-11 targets Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus,influenza virus, coronavirus, metapneumovirus,87633 parainfluenza virus, respiratory syncytialvirus, rhinovirus), multiplex reverse transcription and amplified probe technique, multipletypes or subtypes, 12-25 targets Infectious agent genotype analysis by nucleic acid (DNA or RNA);87910 cytomegalovirus Infectious agent genotype analysis by nucleic acid (DNA or RNA);87912 Hepatitis B virus
    • Optical endomicroscopic image(s), interpretation and report, real-88375 time or referred, eachendoscopic session Influenza vaccine, inactivated, subunit, adjuvanted, for90653 intramuscular use90672 Influenza virus vaccine, quadrivalent, live, for intranasal use Influenza virus vaccine, quadrivalent, split virus, preservative90685 free, when administered tochildren 6-35 months of age, for intramuscular use Influenza virus vaccine, quadrivalent, split virus, preservative90686 free, when administered toindividuals 3 years of age and older, for intramuscular use Influenza virus vaccine, quadrivalent, split virus, when administered to90687 children 6-35 monthsof age, for intramuscular use Influenza virus vaccine, quadrivalent, split virus, when administered to90688 individuals 3 years of age and older, for intramuscular use Hepatitis B vaccine, adult dosage (2 dose schedule), for90739 intramuscular use
    • Interactive complexity (List separately in addition to the90785 code for primary procedure)90791 Psychiatric diagnostic evaluation90792 Psychiatric diagnostic evaluation with medical services Psychotherapy, 30 minutes with patient and/or family90832 member Psychotherapy, 30 minutes with patient and/or family member when performed with anevaluation and90833 management service (List separately in addition to the code for primaryprocedure) Psychotherapy, 45 minutes with patient and/or family90834 member Psychotherapy, 45 minutes with patient and/or family member when performed with anevaluation and90836 management service (List separately in addition to the code for primaryprocedure)
    • Psychotherapy, 60 minutes with patient and/or family90837 member Psychotherapy, 60 minutes with patient and/or family member when performed with anevaluation and90838 management service (List separately in addition to the code for primaryprocedure)90839 Psychotherapy for crisis; first 60 minutes Psychotherapy for crisis; each additional 30 minutes (List90840 separately in addition to code for primary service) Pharmacologic management, including prescription and review of medication, whenperformed with psychotherapy90863 services (List separately in addition to the code for primaryprocedure) Gastrointestinal transit and pressure measurement, stomach91112 through colon, wireless capsule,with interpretation and report Percutaneous transluminal coronary angioplasty; single92920 major coronary artery or branch
    • Get more educationalinformation on the next slide! Percutaneous transluminal coronary angioplasty; each92921 additional branch of a major coronaryartery (List separately in addition to code for primary procedure) Percutaneous transluminal coronary atherectomy, with92924 coronary angioplasty when performed;single major coronary artery or branch Percutaneous transluminal coronary atherectomy, with92925 coronary angioplasty when performed;each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
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