New code changes number 335.
The new current procedural terminology (CPT®) codes have been released with 335 code changes in 2019. There were many code revisions with guideline, description and instructional note changes. Let’s look at the highlights of many new CPT codes for 2019.
There six new codes in the Evaluation and Management (E&M) section in CPT. Guidelines were revised for Interprofessional Telephone/Internet/Electronic Health Record Consultations. New codes 99451 and 99152 were added to report assessment and management services. The codes are based on medical consultative time.
New CPT codes 99453 and 99454 were added to report remote physiologic monitoring services during a 30-day period. Other codes in this section (99446-99449 and 99091) were revised.
These new codes reflect the key role non-verbal communication technology plays in care coordination between consulting and treating physicians, according to the AMA.
CPT code 99457 is a new code that requires live, interactive communication with the patient/caregiver and 20 minutes or more of clinical staff/physician or other qualified health care professional time in a calendar month.
Fine needle aspiration (FNA) codes received new instructional notes including the definition of a fine needle aspiration and a core needle biopsy. Imaging guidance was added to the nine new codes and reporting imaging guidance separately is no longer reportable. Guidelines also direct that the codes are selected based in guidance (included) and add on-codes for each additional lesion, same imaging modality. When using different imaging modalities when more than one lesion is involved, Modifier 59 is appended. CPT code 10021 (FNA) without imaging guidance is reported. CPT code 10022 was deleted and replaced with CPT 10004 for each additional lesion. CPT codes 10005-10012 were added to report the specific imaging guidance (ultrasound, fluoroscopic guidance, CT and MRI).
CPT codes 11100 and 11101 for skin biopsies were deleted. There are new guidelines for coding biopsies and six new codes. The new codes (11102-11107) for skin biopsies based on method of removal including tangential (shave, scoop, saucerize, curette), punch and incisional.
CPT codes 20932-20934 were added for allografts. CPT 20932 includes templating, cutting, placement and internal fixation; osteoarticular, whereas CPT 20933 is hemicortical, intercalary, partial and CPT 20934 is hemicortical, complete.
CPT 27369 was added to report an injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography. CPT code 27370 was deleted likely due to being reported incorrectly as arthrocentesis or aspiration.
New CPT codes 33274 and 33274 are used for reporting a transcatheter insertion or replacement and removal of a permanent leadless pacemaker, right ventricle. Codes 33285 and 33286 have been created for the insertion and removal of a subcutaneous cardiac rhythm monitor and CPT 33289 is for a transcatheter implantation of a wireless pulmonary artery pressure sensor. New CPT code 93264 is used to report remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days.
CPT 33440 was added for the replacement of the aortic valve by translocation with CPT code 33866 created for an aortic hemiarch graft.
New CPT codes 36572 and 36573 are used for an insertion of a peripherally inserted central venous catheter (PICC) without a subcutaneous port or pump. Codes are selected based on age. New CPT code 38531 is used to report a biopsy or excision of an open inguinofemoral lymph node.
Changes were made to the gastrostomy tube placement codes. CPT code 43760 was deleted and two new codes were created. CPT 43762 is reported for the percutaneous gastrostomy tube placement including removal without imaging or endoscopic guidance not requiring revision of the gastrostomy tract and CPT 43763 requires revision of gastrostomy tract. These codes were added to define simple versus complex replacement of a percutaneous gastrostomy tube.
CPT codes 50436 and 50437 are used to report dilation of existing tract, percutaneous for an endourologic procedure including imaging guidance with post procedural tube placement. CPT 50437 is reported when new access into the renal collecting system is performed.
New CPT code 53854 was added to report a transurethral destruction of prostate tissue by radiofrequency generated water vapor thermotherapy.
New codes were established for ultrasound elastography, CPT 76981-76983. These new codes distinguish reporting, per organ, first target lesion and each additional target lesion. Magnetic resonance elastography is new diagnostic imaging technology.
New CPT code 76391 is used to report Magnetic resonance (vibration) elastography.
Two new CPT codes 76978-76979 are used to report ultrasound procedures that use dynamic microbubble-sonographic contrast with targeted ultrasound to evaluation lesions.
Four new breast MRI procedures were added (77046-77049). Codes are selected based on laterality (unilateral vs. bilateral) and with or without contrast material. CPT codes 77058 and 77059 were deleted.
CPT code 90689 was added to report an inactivated adjuvanted preservative free flu vaccination.
In the Ophthalmology section, new codes 92273 and 92274 were added. These are eletroretinography procedures to evaluate function of the retina and optic nerve of the eye. CPT 92273 was added to report global response of photoreceptors of the retina and CPT 92274 to report photoreceptors in multiple separate locations in the retina and macula.
In the Electrocorticography section, CPT 95836 (electrocorticogram) was added to report recording of ECoG from electrodes chronically implanted on or in the brain to allow for intracranial recordings to continue after the patient has been discharged from the hospital.
New guidelines and new CPT codes were added to the Central Nervous System Assessments/Tests including 96112 and 91113 for developmental test administration based on time. CPT add on code 96121 for a neuro behavioral status examination for ab additional hour was added. Under Testing Evaluation Services CPT codes 96130-96133 were added for neuropsychological testing evaluation services based on time.
CPT codes 96136-96139 were added to report psychological or neuropsychological report testing and scoring. Codes are based on time and whether the service was performed by a technician or clinician. CPT code 96146 is used to report psychological or neuropsychological automated testing using an electronic platform.
New codes for programming a neurostimulator were added with CPT odes 95976-95984. Codes are selected based on the nerve selected and simple versus complex.
Eight new CPT codes 97151-97158 and guidelines were added to Adaptive Behavioral services to address deficient adaptive behaviors.
Lastly, there are numerous path and lab codes and category III codes also added this year.
While underdosing is no longer a new concept in coding it remains a common area of confusion. Underdosing is when a patient takes less of
This a heads-up on a definitional change coming our way. There will be the launching of a new framework for obesity in mid-January, per a
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