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January 1, 2016
2016 CPT Changes
Advanced Billing Consultants, Inc.
• This presentation was designed with the clients of
Advanced Billing Consultants in mi...
Advanced Billing Consultants, Inc.
• New:
▫ 99415, 99416: prolonged clinical staff service direct pt
contact w/ phys super...
Advanced Billing Consultants, Inc.
• New:
▫ 43210: Trans-oral approach for Esophagogastroduodenoscopy
▫ 47537: injection p...
Advanced Billing Consultants, Inc.
• Deleted:
▫ 50392, 50393, 50394, 50398
• New
▫ 50430 injection procedure for antegrade...
Advanced Billing Consultants, Inc.
• Deleted: 64412-64999
• New:
▫ 64461: paravertebral block, thoracic
▫ 64462; second an...
Advanced Billing Consultants, Inc.
• New
▫ 69209: removal impacted cerumen using irrigation/lavage,
unilateral (when no in...
Advanced Billing Consultants, Inc.
• There are many changes to Lab codes, for complete list see:
https://www.cms.gov/Medic...
Advanced Billing Consultants, Inc.
• Deleted: 13 outdated vaccine codes
• New:
▫ 90625: cholera vaccine
▫ 90697: (DTap-IPV...
Advanced Billing Consultants, Inc.
• Deleted: 95973 (95972 revised to remove time element)
• New:
▫ 93050: arterial pressu...
Advanced Billing Consultants, Inc.
• There are many changes to drug codes (Q and J). Complete
list can be found at: CMS Le...
Advanced Billing Consultants, Inc.
• There are a lot of new PQRS reporting codes. The complete
list can be found at: 2016 ...
Advanced Billing Consultants, Inc.
• New
▫ 0381T: external heart rate recordings
▫ 0385T/0386T: more external heart rate r...
Advanced Billing Consultants, Inc.
30021 Tomas, Suite 250
Rancho Santa Margarita, CA 92688
Phone: 888-222-2125
Fax: 949-71...
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2016 CPT Changes

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2016 CPT Change by Advanced Billing Consultants

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2016 CPT Changes

  1. 1. January 1, 2016 2016 CPT Changes
  2. 2. Advanced Billing Consultants, Inc. • This presentation was designed with the clients of Advanced Billing Consultants in mind. It is not all inclusive. Please refer to CPT and AMA for a complete listing of all deletions, additions, and revisions to the code sets. Disclaimer
  3. 3. Advanced Billing Consultants, Inc. • New: ▫ 99415, 99416: prolonged clinical staff service direct pt contact w/ phys supervision; beyond 45 mins, plus each additional 30 mins (not counting the services done like PT/INR, ect.) E/M changes
  4. 4. Advanced Billing Consultants, Inc. • New: ▫ 43210: Trans-oral approach for Esophagogastroduodenoscopy ▫ 47537: injection procedure for cholangiography, percutaneous through an existing access site ▫ 47532: same as 47537 but new access ▫ 47534: placement of biliary drainage catheter ▫ 47535: conversion of external biliary drainage catheter to internal-external biliary drainage catheter ▫ 47536: exchange of biliary drainage catheter ▫ 47537: removal of biliary drainage catheter ▫ 47538, 47539, 47540: placement of stent into a bile duct ▫ 47541: placement of access through the biliary tree to assist with an endoscopic biliary procedure ▫ 47542: balloon dilation of biliary ducts to allow for passage of stones (add on code) ▫ 47543: endoluminal biopsy of biliary tree (add on) ▫ 47544: removal of calculi/debris from biliary ducts or gallbladder, any method (add on code) ▫ 49185: sclerotherapy of a fluid collections, percutaneous Digestive System
  5. 5. Advanced Billing Consultants, Inc. • Deleted: ▫ 50392, 50393, 50394, 50398 • New ▫ 50430 injection procedure for antegrade nephrostogram and or ureterogram, new access ▫ 50431; existing access ▫ 50432: placement of nephrostomy catheter, percutaneous ▫ 50433; new access ▫ 50434: Convert nephrostomy catheter to nephroureteral catheter ▫ 50435: Exchange nephrostomy ▫ 50606: Endoluminal biopsy of ureter non-endoscopic (add on) ▫ 50693: placement of ureteral stent, percutaneous; pre-existing nephrostomy tract ▫ 50694; new acces, w/o separate nephrostomy catheter ▫ 50695; new acces, with separate nephrostomy catheter ▫ 50705: ureteral occlusion (add on) ▫ 50706: balloon dilation, ureteral stricture (add on) ▫ 54437: repair of traumatic corporeal tear (penis fracture) ▫ 54438: replantation, penis Urinary System
  6. 6. Advanced Billing Consultants, Inc. • Deleted: 64412-64999 • New: ▫ 64461: paravertebral block, thoracic ▫ 64462; second and any additional injection sites (add on) ▫ 64463; continuous infusion by catheter Nervous System
  7. 7. Advanced Billing Consultants, Inc. • New ▫ 69209: removal impacted cerumen using irrigation/lavage, unilateral (when no instrument used- use 69210 if instrument is used.) Mod 50 allowed Auditory System
  8. 8. Advanced Billing Consultants, Inc. • There are many changes to Lab codes, for complete list see: https://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/ClinicalLabFeeSched/Downloads/CLFS-CY2016- Preliminary-Payment-Determinations.pdf • Deleted: G0431, G0434 • New ▫ G0477-G0483: drug screens Lab Codes
  9. 9. Advanced Billing Consultants, Inc. • Deleted: 13 outdated vaccine codes • New: ▫ 90625: cholera vaccine ▫ 90697: (DTap-IPV-Hib-HepB) ▫ 90620: Men B 2 dose ▫ 90621: MenB 3 dose Medicine: Vaccines
  10. 10. Advanced Billing Consultants, Inc. • Deleted: 95973 (95972 revised to remove time element) • New: ▫ 93050: arterial pressure waveform analysis (replaced 0311T) ▫ 96931-96936: reflectance confocal microscopy imaging of skin (RCM) Cardiovascular and Pulmonary
  11. 11. Advanced Billing Consultants, Inc. • There are many changes to drug codes (Q and J). Complete list can be found at: CMS Level II HCPCS Coding Decisions for the 2015-2016 Coding Cycle [ZIP, 43KB] • Deleted: J7302 • New: ▫ J7297: Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 3 year duration ▫ J7298; 5 year duration ▫ J1575: Injection, immune globulin/hyaluronidase, 100 mg immunoglobulin ▫ J0695: Injection, ceftolozane 50 mg and tazobactam 25 mg Drug Codes
  12. 12. Advanced Billing Consultants, Inc. • There are a lot of new PQRS reporting codes. The complete list can be found at: 2016 PQRS Measures List Reporting Codes (G-codes)
  13. 13. Advanced Billing Consultants, Inc. • New ▫ 0381T: external heart rate recordings ▫ 0385T/0386T: more external heart rate recordings ▫ 0387T-0391T: permanent leadless pacemaker Category III codes
  14. 14. Advanced Billing Consultants, Inc. 30021 Tomas, Suite 250 Rancho Santa Margarita, CA 92688 Phone: 888-222-2125 Fax: 949-713-2931 info@advancedbillingconsultants.com

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