The document provides information on changes to CPT codes for 2012, including: 1) Combining spine, injection, and knee/shoulder arthroscopy codes that are reported together 75% of the time. 2) Re-assessing RVU values for codes that no longer require inpatient stays. 3) Adding new skin graft and spine fusion codes, and revising hemilaminectomy and injection guidance codes. 4) Combining meniscectomy codes with debridement codes and making shoulder arthroscopy codes add-on codes.

1. Month End Deadline
Month End Deadline
This is a reminder that surgery charges received after 12:00pm on Wednesday
2012 CPT Coding
January 4, 2012 will be entered as January charges.
Changes
2012 CPT Coding Changes
There are several CPT changes for 2012 involving both the CPT codes
themselves, and also the RVU values for many codes. The AMA RUC
Committee reviews every CPT code every 5 years, and any new codes are
reviewed for the first time after 3 years. There were 2 main reasons for RVU
adjustments to CPT codes in the musculoskeletal system this year.
1. When two or more procedures are reported together 75% or
more of the time, the RUC Committee reviews combining
these codes together. This continues to affect spine
procedures, injections, and in 2012, knee and shoulder
arthroscopy.
2. Many codes were originally valued with the post operative
period including an inpatient hospital stay. When the codes
are reviewed, if they no longer require an inpatient stay, their
RVU value is re-assessed. This is called the Site of Service
Anomaly. The codes affected by this for 2012 are 28725,
28730, 27385, 27530, 28002, 28285, 28715, 28825, 28120,
28122, and 27792.
Integumentary System
o Many skin grafting codes have been deleted due to the
frequent addition of methods of skin grafting. Deleted codes
have been replaced with new codes listed under “Skin
Substitute Grafts”, 15271-15278.
Musculoskeletal System
o Spine
Two new codes have been added to report posterior
fusion and PLIF with one code. 22612-22614 and
2630-22632 are now combined in 22633-22634.
They have added guidelines to allow codes for
additional levels of arthrodesis to be interchangeable
so that only one primary code is listed, but the
appropriate level additional level code can be
reported.
For Questions, please contact
Lynn M. Anderanin, CPC,CPC-I, COSC
Sr. Director of Coding Compliance and Education
847-720-7090
landeranin@healthinfoservice.com

2. There has been a revision to the hemilaminectomy codes 63020, 60303, and 63035 to include
endoscopically assisted approaches.
A new guideline has been added to the instrumentation section that stated that when
removing or revising of instrumentation is performed as well as insertion of new
instrumentation at the same level(s), only the insertion should be billed.
o Injections
Guidance for epidural or subarachnoid injections has been added to 62310, 62311.
Nerve destruction by neurolytic agent codes, 64622- 64623 and 64626-64627 have been
replaced by new codes, 64633-64636, that include fluoroscopic or CT guidance.
The sacroiliac joint CPT code 27096 has been revised to include the arthrography, and the
arthrography code 73542 has been deleted.
o Xialflex Injections
Two CPT codes have been added for the procedures performed for Xiaflex injections.
20527- Xialflex injection on Day 1
26431- Manipulation after a Xiaflex injection on Day 2
o Knee Arthroscopy
Meniscectomy codes 29880 and 29881 now will include chondroplasty/debridement(29877)
regardless of whether it is performed in the same compartment or different compartments.
29880-29881 and 29877 can no longer be billed together.
o Shoulder Arthroscopy
CPT code 29826 represents subacromial decompression and/or acromioplasty. The AMA found in
their review of this code 95% of the time it is billed with other shoulder arthroscopy procedures,
so they have now revised the code to be an add on code, and it cannot be billed without at least
one other arthroscopic shoulder procedure.
Radiology
o Spine X-rays
72114 Radiologic examination, spine, lumbosacral, complete, including bending views has been
revised to include that a minimum of 6 views is necessary.
72120- Radiologic examination, spine, lumbosacral, bending views only, minimum of 4 views, has
been revised to only include 2 or 3 views