New options replace 49420 for tunneled catheter. Choosing an intraperitoneal catheter insertion used to mean deciding between “permanent” and “temporary” — but CPT 2011 changes all that. Now you’ll need to know if the procedure is open, lap...
Correct Coding Initiative version 17.1 brings 11,831 new edit pairs, effective April 1 for physicians. That’s the word from a March 17 announcement by Frank Cohen, principal and senior analyst for the Frank Cohen Group. Here’s a look at the major pointers you need to keep in mind to comply with the new cardiology-related edits, including cardiac catheterization, radiological supervision and interpretation, cardiac rehabilitation, and more.
1. Prevent Denials by Remembering 93454-93461 Are Diagnostic
New edits will prevent you from reporting heart catheter/angiography codes 93454- 93461 (column 2) with the following cardiovascular therapeutic services and procedures (column 1):
The 929xx codes in column 1 describe coronary therapies. The 934xx codes in column 2 are diagnostic procedures. You should never use the 934xx diagnostic codes in column 2 to report catheter placement and coronary angiography performed as an integral part of the therapeutic column 1 services.
Opportunity: The edits have a modifier indicator of 1, so you may override them with an appropriate modifier when the procedures are distinct. If you report both codes in the edit pair and don’t append a modifier to the column 2 code, Medicare (and payers applying Medicare rules) will reimburse you for only the column 1 code.
The AMA, via CPT Assistant (April 2005), indicates that you may report a true diagnostic catheterization in addition to the therapeutic procedures described by 92980 and 92982: “These two distinct procedures (diagnostic catheterization and therapeutic procedures), therefore, should...
Capture additional pay by separating wound care management codes 97597-97602 from the newly revised debridement codes.
Every year, just when you’re trying to get used to new CPT codes, the Correct Coding Initiative (CCI) comes along and limits how and when you can use the new codes you’ve been given. This year is no exception with CCI 17.0 adding edits involving new Renessa and posterior tibial neurostimulator (PTNS) codes, among others.
The CCI released version 17.0, revealing 19,822 new active pairs and 9,778 code pair deletions, said Frank D. Cohen, MPA, MBB, senior analyst with The Frank Cohen Group, LLC, in a Dec. 14 announcement.
Many of the new code pair additions involve CPT codes that debuted on Jan. 1, 2011 with CCI getting ready to halt payment if you report certain procedures together. Get a grip on the new bundles with this urology-focused rundown.
CPT 2011 deleted Category III code 0193T (Transurethral, radiofrequency microremodeling of the female bladder neck and proximal urethra for stress urinary incontinence), replacing it with a new Category I code 53860 with the same descriptor. CCI targets 53860 with several edits.
When your urologist performs the Renessa procedure, you’ll report 53860, says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York at Stony Brook.
As of Jan. 1, when 53860 became an active code, CCI 17.0 created edit pairs with the following column 2 codes that Medicare considers usual and necessary parts of any surgery:
“In general CPT code 53680 would include catheter placement for temporary postoperative urinary drainage at the conclusion of the procedure, and therefore, these latter...
If you’ve been looking for a code on colon motility study and being frustrated for the lack of it, your search is over. CPT 2011 debuts a new code for a manometric study, along with two revised codes for esophageal pH monitoring.
For gastroenterology, you have a lot of changes to sort through — many involving deletions on low use codes or clean-up work.
Here’s How to Use New Manometric Study Codes
You should pay attention on two new codes for a manometric study: 91117 (Colon motility [manometric] study, minimum 6 hours continuous recording [including provocation tests, e.g., meal, intracolonic balloon distension, pharmacologic agents, if performed], with interpretation and report), and 91013 (Esophageal motility [manometric study of the esophagus and/or gastroesophageal junction] study with interpretation and report; with stimulation or perfusion during 2-dimensional data study [e.g., stimulant, acid or alkali perfusion] [List separately in addition to code for primary procedure]).
CPT 91117 is just for the study itself, not for the same session with catheter placement. The radiologist may place the catheter in a prior procedure and the gastroenterologist may come in and out to supervise the testing and any provocations that are performed. Thus, you should include the provocations in the study and report 97117 only once no matter how many times the testing is done.
You can use 91013 in cases like assessment of the effect on the measured esophageal motility when the patient’s esophagus is exposed to different stimulant liquids, says Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA’s CPT Advisory Panel. The code also applies when intravenous medications are administered to try to produce symptoms. CPT 91010 is included in 91013 and would not be billed separately, he adds.
Use 91034, 91035 in a New Way
Aside from debuting...
Revascularization, heart catheterization, and more all have new looks in CPT 2011. Here’s an overview of what you can expect. • 37220-37235: Endovascular revascularization, open or percutaneous The codes in this range are distinguished by the vesse...
Initial vs. additional access matters in 2010. Love them or hate them, the trend toward guidance-inclusive codes doesn’t seem to be slowing. Case in point: CPT 2010 ousts 36145 (Introduction of needle or intracatheter; arteriovenous shunt created for dialysis [cannula, fistula, or graft]) and 75790 (Angiography, arteriovenous shunt [e.g., dialysis patient], radiological supervision and interpretation) and instead [...] Related articles: