2014 coding changes
DESCRIPTION
2014 Coding Changes. AAPC Richmond Va. chapter January 2014. Overview & Objectives. Identify coding changes for the upcoming year (HIGHLIGHTS) CPT ® HCPCS What's new for 2014- over 330 coding changes. 175 New Codes 47 deleted codes 107 revised codes. CPT ®. Evaluation & Management. - PowerPoint PPT PresentationTRANSCRIPT
2014 Coding ChangesAAPC RICHMOND VA. CHAPTERJANUARY 2014
AAPC Richmond Va. Chapter - January 2014
2Overview & Objectives
Identify coding changes for the upcoming year (HIGHLIGHTS) CPT® HCPCS
What's new for 2014- over 330 coding changes
AAPC Richmond Va. Chapter - January 2014
3
CPT®175 NEW CODES47 DELETED CODES107 REVISED CODES
AAPC Richmond Va. Chapter - January 2014
4Evaluation & Management
Interprofessional Telephone/Internet Consultations (99446 - 99449) four new codes
Time-based!! must document a minimum of 5 minutes to report 99446 Time includes review of medical record, diagnostic test, verbal & written communication
Request from treating physician to consultant for opinion and/or treatment advice to assist in the diagnosis and/or management of the patient
no face to face w/ patient Complex and/or urgent situations where a timely face-to-face service with the
consultant may not be feasible New patient to consultant or Established patient with new problem or exacerbation of
an existing patient No face-to-face with consultant last 14 days or next 14 days Report only once in a seven day period
AAPC Richmond Va. Chapter - January 2014
5Evaluation & Management (cont.)
Complex Chronic Care Coordination Services(99487 - 99489) Codes did not change Guidelines revised to detail:
Typical adult patients Typical pediatric patients Requirements for care
coordination offices/practices
Requirements: Provide 24/7 access to clinical staff Use standardized methodology to
identify CCCC patients Internal process whereby identified
patients being receiving treatment in a timely manner
Standardized medical record form and format
Engage and educate patients and caregivers and coordinate care among all service professionals
AAPC Richmond Va. Chapter - January 2014
6Evaluation & Management (cont.)
Transitional Care Management Services(99495 - 99496) Codes did not change/ just revised Can report for new or established patients Separately reported E&M cannot be reported on the same
day Discharge service may not be used as required face-to-face
visit
AAPC Richmond Va. Chapter - January 2014
7Integumentary - Lund-Browder (No more “Rule of Nines” in CPT)
Area Birth-1yr
1-4 Yrs 5-9 Yrs 10-14 Yrs
15 Yrs Adult
Head 19 17 13 11 9 7Neck 2 2 2 2 2 2Trunk* 13 13 13 13 13 13Buttock* 2.5 2.5 2.5 2.5 2.5 2.5Genitalia 1 1 1 1 1 1U Arm* 4 4 4 4 4 4L Arm* 3 3 3 3 3 3Hand* 2.5 2.5 2.5 2.5 2.5 2.5Thigh* 2.5 6.5 8 8.5 9 9.5Leg* 5 5 5.5 6 6.5 7Foot* 3.5 3.5 3.5 3.5 3.5 3.5
AAPC Richmond Va. Chapter - January 2014
8Integumentary - Breast Procedures
New biopsy with localization codes: Include localization devices, when performed Include imaging of the biopsy specimen, when performed Differ based on type of guidance
Stereotactic (19081, +19082) Ultrasound (19083, +19084) MRI (19085, +19086)
AAPC Richmond Va. Chapter - January 2014
9Integumentary - Breast Procedures (cont.)
New introduction codes for localization devices Differ based on type of guidance
Mammographic (19281, +19282) Stereotactic (19283, +19284) Ultrasound (19285, +19286) MRI (19287, +19288)
AAPC Richmond Va. Chapter - January 2014
10Musculoskeletal
Tumor resections Changed terminology from: Malignant neoplasm to sarcoma
New and revised codes for removal of foreign body and removal of prosthesis Specifically describes what is removed foreign body or
prosthesis
AAPC Richmond Va. Chapter - January 2014
11Respiratory
Pleural catheter & thoracentesis Parenthetical notes revised to state not to report in
conjunction when performed on the same side of the chest
AAPC Richmond Va. Chapter - January 2014
12Cardiovascular
Pacemaker or Pacing Cardioverter Defibrillator Guidelines revised
Relocation of skin pocket: requires creation of a new skin pocket Revision of skin pocket, not reported separately Subcutaneous implantable defibrillator system
TAVI/TARI new code for transapical exposure
AAPC Richmond Va. Chapter - January 2014
13Cardiovascular (cont.)
New codes Fenestrated Endovascular Repair of the Visceral and
Infrarenal Aorta (34841 - 34848) Transcather placement of an intravascular stent(s) (37217,
37236 - 37239) Vascular Embolization and Occlusion (37241 - 37244)
AAPC Richmond Va. Chapter - January 2014
14Digestive - BIG CHANGES
Endoscopy codes: specifically rigid and flexible esophagoscopy= significant changes
13 new codes Description revision for nearly all remaining
codes New parenthetical instructions
AAPC Richmond Va. Chapter - January 2014
15Digestive - BIG CHANGES
Esophagoscopy (43191 - 43232) Esophagogastroduodenoscopy (43233 -
43259) Endoscopic Retrograde
Cholangiopancreatography - ERCP (43260 - 43278)
Abdomen, Peritoneum, and Omentum - Introduction, Revision, and Removal
AAPC Richmond Va. Chapter - January 2014
16Digestive (cont.)
Esophagoscopy Cricopharyngeus muscle (upper esophageal sphincter)
to and including the gastoesophageal junction Includes examination of the proximal region of the
stomach via retroflexion when performed Selecting code need to know if a rigid or flexible
scope is used Reason for separating the code is the different
types of anesthesia used
AAPC Richmond Va. Chapter - January 2014
17Digestive (cont.)
Esophagogastroduodenoscopy (AKA: Upper GI) Cricopharyngeus muscle (upper esophageal
sphincter) to and including the duodenum Consistent terminology Explanation of proper modifier use
Duodenum deliberately not examined Modifier 52 - Repeat examination not planned Modifier 53 - Repeat examination planned
AAPC Richmond Va. Chapter - January 2014
18Digestive (cont.)
ERCP Requires visualization of one or more of the ductal
systems Pancreatic Biliary
Altered postoperative anatomy Unlisted codes (47999 or 48999) for ERCP via
gastrostomy or via Roux-en-Y
AAPC Richmond Va. Chapter - January 2014
19Digestive (cont.)
New codes for image-guided fluid collection draining by catheter (abdomen, peritoneum, and omentum) 49405 Visceral Percutaneous 49406 Peritoneal or Retroperitoneal, Percutaneous 49407 Peritoneal or Retroperitoneal, Transvaginal or
Transrectal
AAPC Richmond Va. Chapter - January 2014
20Urinary
One new code Combination code
52356 Cystourethroscopy with ureteroscopywith lithotripsy including insertion of
indwelling ureteral stent(eg, Gibbons or double-J type)
AAPC Richmond Va. Chapter - January 2014
21Nervous
New Codes in the Chemodenervation Section - Somatic Nerves 64616 Neck muscle(s) excluding larynx (unilateral) 64617 Larynx, unilateral, percutaneous
includes needle EMG guidance 64642 One extremity; 1 -4 muscles +64643 Each additional extremity, 1 - 4 muscles 64644 One extremity; 5+ muscles +64645 Each additional extremity, 5+ muscles 64646 Trunk muscles; 1 - 5 muscles 64647 Trunk muscles; 6+ muscles
AAPC Richmond Va. Chapter - January 2014
22Eye & Ocular Adnexa
One new code - Anterior Sclera - Aqueous Shunt 66183 Insertion of anterior segment aqueous drainage
device, without extraocular reservoir, external approach
Replaces the category III code 0192T
AAPC Richmond Va. Chapter - January 2014
23Auditory System
Guideline for cerumen removal 69210 Clarifies that an instrument is required Revised to report unilateral procedure (continue to use
modifier 50 for bilateral procedures) Added guidance from CPT® Assistant
AAPC Richmond Va. Chapter - January 2014
24Radiology
Radiologic exam of spine 72040 now specifies “2 or 3 views instead of “3 or less”
Revisions to guidance codes and parenthetical references based on codes for which guidance is now included: Transcatheter Procedures- supervision included in new codes 37236-37239 Fluoroscopic Guidance Magnetic Resonance Guidance
Revisions to radiation oncology simulation guidelines: inappropriately described as “simulation”, more appropriately labeled as “planning”
AAPC Richmond Va. Chapter - January 2014
25Pathology & Laboratory
New Molecular Pathology Table Expansion of molecular pathology parenthetical lists of
included items 10 New Therapeutic Drug Assay Codes
AAPC Richmond Va. Chapter - January 2014
26Medicine
Vaccines - New Flu Codes Includes four strains (two type A and two type B) Patients age determines the code
Special Otorhinolaryngologic Services New speech related codes
Repair of Structural Heart Defects Two new percutaneous transcatheter repair codes
Intracardiac Electrophysiological Procedures/Studies 3 revised codes - all for comprehensive electrophysiologic evaluations
AAPC Richmond Va. Chapter - January 2014
27Medicine (cont.)
Intraoperative Neurophysiology Guidelines revised to define specifically what the time monitoring
and time in the OR includes Monitoring - Time to set up, record, and interpret the baseline studies,
and to remove electrodes at the end of the procedure OR - Time is cumulative and only includes time physically present in the
room; may begin prior to incision Active Wound Care Management
One new code - low frequency non-contact non-thermal US for wound assessment (per day)
AAPC Richmond Va. Chapter - January 2014
28Next Steps
Review all new codes, guidelines, and parenthetical Highlight the changes for your specialty
New guidelines/parenthetical printed in green. Look in the index for any changes. Update coding cheat sheets with the new codes Make sure super bills, charge masters are updated with the new
codes Load new codes into software Educate staff on changes
AAPC Richmond Va. Chapter - January 2014
29Questions? & Reminders…
Current 2014 CPT 2014 CPT® Errata 2014 CPT® Changes: An Insider’s View CPT Assistant AHA Coding Clinic
AAPC Richmond Va. Chapter - January 2014
30Contact Information
Presentation Prepared by- Chandra Stephenson, CPC, CPC-H, CPCO, CPMA, CPC-I, CANPC, CEMC, CFPC, CIMC, COSC
Presentation Presented by- Colleen Mescall, MHA/E, CPC, CPMA, CPC-I, 2014 RAC President, 2013-2015 National Advisory Board Member