-
a b e o | W E K N O W C O D I N G .
Page 1
The updated code set should be used for claims filed for dates of service - Jan. 1, 2017
2017 CPT PROCEDURE CODING UPDATE GUIDE
-
a b e o | W E K N O W C O D I N G .
Page 2
Table of Contents ...................................................................................................................................................................... 6 INTRODUCTION
.............................................................................................................................. 7 EVALUATION AND MANAGEMENT (E/M)
............................................................................................................................................ 7 Preventive Medicine Services
Counseling Risk Factor Reduction and Behavior Change Intervention .......................................................................... 7
........................................ 7 Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
Pediatric Critical Care Patient Transport ........................................................................................................................ 7
Inpatient Neonatal and Pediatric Critical Care ............................................................................................................... 7
........................................................................................................................................................................... 8 ANESTHESIA
........................................................................................................................................................ 8 Anesthesia Guidelines
........................................................................................................................................................... 8 Other Procedures
................................................................................................................................................................................ 9 SURGERY
....................................................................................................................................................... 9 Integumentary System
Skin, Subcutaneous, and Accessory Structures .............................................................................................................. 9
Nails .............................................................................................................................................................................. 10
................................................................................................................................................... 10 Musculoskeletal System
Head ............................................................................................................................................................................. 11
Spine (Vertebral Column) ............................................................................................................................................. 11
Pelvis and Hip Joint ...................................................................................................................................................... 16
Foot and Toes ............................................................................................................................................................... 16
.......................................................................................................................................................... 17 Respiratory System
Larynx ........................................................................................................................................................................... 17
Trachea and Bronchi .................................................................................................................................................... 20
..................................................................................................................................................... 20 Cardiovascular System
Heart and Pericardium ................................................................................................................................................. 21
Electrophysiologic Operative Procedures .................................................................................................................... 21
Cardiac Valves .............................................................................................................................................................. 21
Arteries and Veins ........................................................................................................................................................ 23
Vascular Embolization and Occlusion .......................................................................................................................... 29
......................................................................................................................................... 30 Hemic and Lymphatic Systems
Lymph Nodes and Lymphatic Channels ....................................................................................................................... 30
.............................................................................................................................................................. 31 Digestive System
-
a b e o | W E K N O W C O D I N G .
Page 3
Esophagus .................................................................................................................................................................... 31
Anus ............................................................................................................................................................................. 32
Biliary Tract .................................................................................................................................................................. 32
................................................................................................................................................................. 32 Urinary System
Bladder ......................................................................................................................................................................... 32
........................................................................................................................................................ 32 Male Genital System
Prostate ........................................................................................................................................................................ 32
..................................................................................................................................................... 33 Female Genital System
Oviduct/Ovary .............................................................................................................................................................. 33
............................................................................................................................................................... 33 Nervous System
Skull, Meninges, and Brain ........................................................................................................................................... 33
Spine and Spinal Cord .................................................................................................................................................. 33
Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System .................................................................. 36
.................................................................................................................................................... 36 Eye and Ocular Adnexa
Posterior Segment ........................................................................................................................................................ 36
Conjunctive .................................................................................................................................................................. 36
............................................................................................................................................................... 37 Auditory System
.......................................................................................................................................................................... 38 RADIOLOGY
Diagnostic Radiology (Diagnostic Imaging) ...................................................................................................................... 38
Spine and Pelvis ............................................................................................................................................................ 38
Vascular Procedures ..................................................................................................................................................... 38
Diagnostic Ultrasound ...................................................................................................................................................... 39
Abdomen and Retroperitoneum .................................................................................................................................. 39
Genitalia ....................................................................................................................................................................... 39
Ultrasonic Guidance Procedures .................................................................................................................................. 40
Radiologic Guidance ......................................................................................................................................................... 40
Fluoroscopic Guidance ................................................................................................................................................. 40
Breast, Mammography ................................................................................................................................................ 41
............................................................................................................................................................. 41 Nuclear Medicine
Diagnostic ..................................................................................................................................................................... 41
.......................................................................................................................................... 42 PATHOLOGY AND LABORATORY
Organ or Disease-‐Oriented Panels ............................................................................................................................... 42
Drug Assay .................................................................................................................................................................... 42
-
a b e o | W E K N O W C O D I N G .
Page 4
Molecular Pathology .................................................................................................................................................... 43
............................................................................................................................................................................. 47 MEDICINE
.......................................................................................................................................................................... 47 Medicine
Vaccines, Toxoids ......................................................................................................................................................... 47
......................................................................................................................................................................... 48 Psychiatry
Psychiatric Diagnostic Procedures ............................................................................................................................... 48
................................................................................................................................................................ 49 Ophthalmology
Special Ophthalmological Services ............................................................................................................................... 49
............................................................................................................................. 50 Special Otorhinolaryngologic Services
Evaluative and Therapeutic Services ............................................................................................................................ 50
.................................................................................................................................................................. 51 Cardiovascular
Therapeutic Services and Procedures .......................................................................................................................... 51
Implantable and Wearable Cardiac Device Evaluations ............................................................................................... 51
Cardiac Catheterization ................................................................................................................................................ 51
......................................................................................................................... 52 Noninvasive Vascular Diagnostic Studies
Visceral and Penile Vascular Studies ............................................................................................................................ 52
.................................................................................................................................................................. 52 Endocrinology
..................................................................................................................... 53 Neurology and Neuromuscular Procedures
............................................................................................................... 53 Health and Behavior Assessment/Intervention
Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly
.................................................................................... 53 Complex Drug or Highly Complex Biologic Agent Administration
.................................................................................................................................. 53 Special Dermatological Procedures
.............................................................................................................................. 54 Physical Medicine and Rehabilitation
....................................................................................................................................... 56 Moderate (Conscious) Sedation
........................................................................................................................................ 57 Other Services and Procedures
........................................................................................................................................................................ 58 CATEGORY III
............................................................... 58 Deleted and Revised Codes with Parenthetical Changes/Additions/Revisions
....................................................................................................................................................................... 62 New Codes
Cardiac Contractility Modulation Procedures .............................................................................................................. 62
General Procedures ...................................................................................................................................................... 63
Phrenic Nerve Stimulation System ............................................................................................................................... 63
General Procedures ...................................................................................................................................................... 64
-
a b e o | W E K N O W C O D I N G .
Page 5
Implantable Aortic Ventricular Assistance Systems for Congestive Heart Failure ....................................................... 65
........................................................................................................................................................................ 68 Appendix A
.......................................................................................................................................................................... 68 Modifiers
................................................................. 68 Modifiers Approved for Ambulatory Surgery (ASC) Hospital Outpatient Use
.......................................................................................................................................................................... 68 Reminder
........................................................................................... 68 Modifier -‐59 and the Modifiers XE, XS, XP, and XU Usage
-
a b e o | W E K N O W C O D I N G .
Page 6
INTRODUCTION The purpose of this CPT code set update guide is to provide details of the additions, deletions, and revisions for CPT 2017. The changes represent physician practice changes and technology improvements. There were 726 code changes for 2017 with quite a few changes in Cardiac in both the Surgery section and the Medicine section. Of the total changes: 81 codes were deleted 148 new codes were added to 2017’s CPT code list 497 codes were revised*
*NOTE: Moderate (Conscious) Sedation has been removed as an integral component for procedures. New codes have replaced the old ones. This service can now, with appropriate documentation, be separately coded (see the section in the Medicine Chapter showing both deleted and new codes with requirements). This accounts for the large number of revised codes in 2017. We have included a segment prior to each section listing the CPT codes affected by this change. The AMA and CMS do not allow for a transition period. Providers must bill with new CPT codes for dates of service on or after January 1, 2017. We will continue to report 2016 codes for dates of service prior to January 1, 2017 submitted on or after January 1, 2017. Please refer to the CPT 2017 codebook for a complete listing of new and revised CPT® 2017 codes and guidelines. Below is a summary of the actual 2017 CPT code changes:
Category New Codes
Revised Codes Deleted Codes Total Changes
Evaluation & Management 0 0 1 1 Anesthesia 0 0 0 0 Surgery 51 360* 29 440 Radiology 4 7 11 22 Pathology/Laboratory 11 6 8 25 Medicine 26 109* 14 149 Category III 56 15 18 89 Total 148 497* 81 726
Action Steps:
Ø Review the 2017 CPT coding changes along with all guideline changes found throughout. Ø Update charge capture tools, electronic health record (EHR) lists and short lists or favorites, if capture is
performed within the EHR. Ø Train all staff and clinical providers on coding changes. Ø Review and update superbills, templates, and chargemasters, etc.
-
a b e o | W E K N O W C O D I N G .
Page 7
EVALUATION AND MANAGEMENT (E/M) Preventive Medicine Services Counseling Risk Factor Reduction and Behavior Change Intervention New or Established Patient Behavior Change Interventions, Individual Parenthetical Note Revision Under code 99408 and 99409, the parenthetical note has been revised to reflect the deletion of code 99420 and the establishment of new codes: Do not report 99408, 99409 with 96160 or 961613
Other Preventive Medicine Services Deleted Code
Change Type
CPT Code CPT Descriptor Change Detail
New ●# 99420 Administration and interpretation of health risk assessment instrument (eg, health hazard appraisal)
-‐To report, see 96160, 96161
Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services Pediatric Critical Care Patient Transport Guideline Revisions Several paragraphs in the guidelines have been revised to change the wording replacing the word “are” with “may be” in various parts. The intended use of the guidelines has not changed. Inpatient Neonatal and Pediatric Critical Care Guideline Revisions Because of the difference in wording but the identical intent of the paragraphs, the wording has been modified to match between the second and third paragraphs of the guidelines addressing the neonatal codes (99468, 99469) and the fourth paragraph of the guidelines addressing the pediatric codes (99471-‐99476). The same terminology is used.
-
a b e o | W E K N O W C O D I N G .
Page 8
ANESTHESIA
Key to symbols used: ∆ Revised Code • New Code + Add On Code # Out of Numerical Sequence Code
Anesthesia Guidelines Anesthesia Guideline Changes New instruction has been added regarding moderate (conscious) sedation provided by a physician also performing the service for which conscious sedation is being provided. They are to use new codes 99151, 99152, 99153. For a second physician providing moderate (conscious) sedation other than the health care professional performing the diagnostic or therapeutic services, the new code of 99155, 99156, or 99157 would be used in the facility setting. These codes would not be reported in the non-‐facility setting (eg, physician office, freestanding imaging center). Moderate sedation does not include minimal sedation (anxiolysis), deep sedation, or MAC.
Other Procedures Parenthetical Note Addition A parenthetical note was added under 01992 directing you not to report 01991 or 01992 with new codes 99151, 99152, 99153, 99155, 99156, or 99157 for Moderate (Conscious) Sedation.
-
a b e o | W E K N O W C O D I N G .
Page 9
SURGERY On the following pages are the listings of new, revised, and deleted codes contained within the Surgery Section of CPT® 2017 per system. Also included are brief descriptions of parenthetical and guideline changes pertinent to the codes.
2017 CPT Surgery Changes Category New Codes Revised
Codes Deleted Codes Total
Changes Integumentary System 0 2 1 2 Musculoskeletal System 11 18 8 37 Respiratory System 12 78 13 103 Cardiovascular System 16 83 3 102 Digestive System 2 155 0 157 Urinary System 0 18 0 18 Female Genital System 1 1 0 2 Nervous System 9 1 4 14 Eye and Ocular Adnexa 0 3 0 3 Auditory System 0 1 0 1 Total 51 360 29 440
Key to symbols used:
∆ Revised Code • New Code + Add On Code # Out of Numerical Sequence Code
Integumentary System Moderate (Conscious) Sedation Revised Codes for This Section Change Type
CPT Code
Change Detail
Revised ∆ 10030
-‐ Moderate sedation has been removed as an inclusive component of these procedures 19298
Skin, Subcutaneous, and Accessory Structures Introduction and Removal Revised Code Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 10030 Image-‐guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous
-‐The “Modifier 51 exempt” status has been removed from this code
Incision and Drainage
-
a b e o | W E K N O W C O D I N G .
Page 10
Parenthetical Note Change Under code 10160, a parenthetical note was revised to add 77002 to the list of codes when imaging guidance is performed.
Nails Deleted Code
Change Type
CPT Code
CPT Descriptor Change Detail
Deleted 11752 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal; with amputation of tuft of distal phalanx
-‐To report, see 26236, 28124, or 28160
Parenthetical Note Change Under code 11750, a parenthetical note has been added advising the used of 15050 for a pinch graft.
Musculoskeletal System Moderate (Conscious) Sedation Revised Codes for This Section Change Type CPT Code CPT Code Change Detail
Revised ∆
20982 22513
-‐ Moderate sedation has been removed as an inclusive component of these procedures
20983 22514 22510 22515 22511 22526 22512 22527
Excision Parenthetical Note Change Under code 20206, a parenthetical note was revised to add 77002 to the list of codes when imaging guidance is performed. Revised Codes
Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 20240 Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)
-‐The “e.g.” examples have been revised from “eg, ilium, sternum, spinous process, ribs, trochanter of femur”
Revised ∆ 20245 deep (eg, humeral shaft, ischium, femur shaft) -‐ The “e.g.” examples have been revised from “eg, humerus, ischium, femur”
Other Procedures Revised Codes
-
a b e o | W E K N O W C O D I N G .
Page 11
Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 20982 Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency
-‐ The “Modifier 51 exempt” status has been removed from this code
Revised ∆ 20983 cryoablation -‐ The “Modifier 51 exempt” status has been removed from this code
Head Fracture and/or Dislocation Deleted Code
Change Type
CPT Code
CPT Descriptor Change Detail
Deleted 21495 Open treatment of temporomandibular dislocation -‐To report open treatment of hyoid fracture, use 31584
Spine (Vertebral Column) Guideline Additions and Revisions Code 22859 has been added to the list of codes to report instrumentation procedures performed with definitive vertebral procedures. The list of instrumentation procedure codes have been revised to reflect the absence of deleted code 22851 and the addition of new codes to: 22840-‐22848, 22853, 22854, and 22859 that are reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859. Excision Parenthetical Note Revisions Under code 22102, a parenthetical note was revised to reflect the new codes 22867, 22868, 22869, and 22870 that will be replacing the Category III codes of 0171T and 0172T. Under add-‐on code 22116, parenthetical notes have been added noting the absence of deleted code 22851 and the addition of new codes 22853, 22854, and 22859. Osteotomy Guideline Revisions The list of instrumentation procedure codes have been revised to reflect the addition of new code 22859 that would be reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859. Fracture and/or Dislocation Guideline Revisions
-
a b e o | W E K N O W C O D I N G .
Page 12
The list of instrumentation procedure codes have been revised to reflect the addition of new code 22859 that would be reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859. Deleted Code Change Type
CPT Code
CPT Descriptor Change Detail
Deleted 22305 Closed treatment of vertebral process fracture(s) -‐To report, see the appropriate evaluation and management codes
Percutaneous Vertebroplasty and Vertebral Augmentation Guideline Revisions “Moderate sedation” has been removed from the guidance regarding the inclusive components for a bone biopsy. Revised Codes
Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 22510 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic
-‐ Moderate sedation has been removed as an inclusive component of this procedure
Revised ∆ 22511 lumbosacral -‐ Moderate sedation has been removed as an inclusive component of this procedure
Revised ∆ +22512 each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure)
-‐ Moderate sedation has been removed as an inclusive component of this procedure
Revised ∆ 22513 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic
-‐ Moderate sedation has been removed as an inclusive component of this procedure
Revised ∆ 22514 lumbar -‐ Moderate sedation has been removed as an inclusive component of this procedure
Revised ∆ +22515 each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)
-‐ Moderate sedation has been removed as an inclusive component of this procedure
Percutaneous Augmentation and Annuloplasty Revised Codes
-
a b e o | W E K N O W C O D I N G .
Page 13
Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 22526 Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level
-‐ Moderate sedation has been removed as an inclusive component of this procedure
Revised ∆ +22527 1 or more additional levels (List separately in addition to code for primary procedure)
-‐ Moderate sedation has been removed as an inclusive component of this procedure
Arthrodesis Guideline Revisions The list of instrumentation procedure codes have been revised to reflect the absence of deleted code 22851 and the addition of new codes to: 22840-‐22848, 22853, 22854, and 22859 that are reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859. Posterior, Posterolateral or Lateral Transverse Process Technique Guideline Revisions The list of instrumentation procedure codes have been revised to reflect the addition of new code 22859 that would be reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859. Spine Deformity (eg, Scoliosis, Kyphosis) Guideline Revisions The list of instrumentation procedure codes have been revised to reflect the addition of new code 22859 that would be reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859.
Exploration Guideline Revisions The list of instrumentation procedure codes have been revised to reflect the absence of deleted code 22851 and the addition of new codes to: 22840-‐22848, 22853, 22854, and 22859 that are reported in addition to the definitive procedure(s).
Spinal Instrumentation Guideline Revisions The list of instrumentation procedure codes have been revised to reflect the addition of new code 22859 that would be reported in addition to the definitive procedure(s). Modifier 62 may not be appended to the definitive or add-‐on spinal instrumentation procedure code(s) 22840-‐22848, 22850, 22852-‐22854, and 22859.
Non-‐Segmental and Segmental Spinal Instrumentation Parenthetical Additions
-
a b e o | W E K N O W C O D I N G .
Page 14
Following add-‐on codes +22840 and +22841 for Non-‐Segmental Spinal Instrumentation and +22842, +22843, +22844, +22845, +22846, +22847, +22848 for Segmental Spinal Instrumentation, the lists has been modified for those codes that may be used in combination with these codes. They now read: 22100-‐22102, 22110-‐22114, 22206, 22207, 22210-‐22214, 22220-‐2224, 22310-‐22327, 22532, 22533, 22548-‐22558, 22590-‐22612, 22630, 22633, 22634, 22800-‐22812, 63001-‐63030, 63040-‐63042, 63045-‐63047, 63050-‐63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101, 63102, 63170-‐63290, and 63300-‐63307.
New and Deleted Codes Change Type
CPT Code
CPT Descriptor Change Detail
Deleted 22851 Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), methylmethacrylate) to vertebral defect or interspace (List separately in addition to code for primary procedure)
-‐To report, see 22853, 22854, or 22859
New ● +22853 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)
-‐Use with 22100-‐22102, 22110-‐22114, 22206, 22207, 22210-‐22214, 22220-‐2224, 22310-‐22327, 22532, 22533, 22548-‐22558, 22590-‐22612, 22630, 22633, 22634, 22800-‐22812, 63001-‐63030, 63040-‐63042, 63045-‐63047, 63050-‐63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101, 63102, 63170-‐63290, and 63300-‐63307 -‐Report for each treated intervertebral disc space
New ● +22854 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
-‐Use with 22100-‐22102, 22110-‐22114, 22206, 22207, 22210-‐22214, 22220-‐2224, 22310-‐22327, 22532, 22533, 22548-‐22558, 22590-‐22612, 22630, 22633, 22634, 22800-‐22812, 63001-‐63030, 63040-‐63042, 63045-‐63047, 63050-‐63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101, 63102, 63170-‐63290, and 63300-‐63307
New ●# +22859 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
-‐Use with22100-‐22102, 22110-‐22114, 22206, 22207, 22210-‐22214, 22220-‐2224, 22310-‐22327, 22532, 22533, 22548-‐22558, 22590-‐22612, 22630, 22633, 22634, 22800-‐22812, 63001-‐63030, 63040-‐63042, 63045-‐63047, 63050-‐63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101, 63102, 63170-‐63290, and 63300-‐63307 -‐22853, 22854, 22859 may be reported more than once for noncontiguous defects -‐For application of an intervertebral bone device/graft, see 20930, 20931, 20936, 20937, or 20938
Spinal Prosthetic Devices Parenthetical Note
-
a b e o | W E K N O W C O D I N G .
Page 15
Under code 22856, a parenthetical note instructs that this code should not be reported with 22554, 22845, 22853, 22854, 22859, 63075, 0375T when performed at the same level. Under code 22857, a parenthetical note instructs that this code should not be reported with 22558, 22845, 22853, 22854, 22859, or 49010 when performed at the same level. Under code 22861, a parenthetical note instructs that this code should not be reported with 22845, 22853, 22854, 22859, 22864, or 63075 when performed at the same level. Under code 22862, a parenthetical note instructs that this code should not be reported with 22558, 22845, 22853, 22854, 22859, 22865, or 49010 when performed at the same level. New Codes
Change Type
CPT Code
CPT Descriptor Change Detail
New ● 22867 Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
New ● +22868 Second level (List separately in addition to code for primary procedure)
-‐Use with 22867 -‐Do not report either 22867 or 22868 with 22532-‐22534, 22558, 22612, 22614, 22630, 22632-‐22634,22800, 22802, 22804, 22840-‐22842, 22869, 22870, 63005, 63012, 63017, 63030, 63035, 63042, 63044, 63047, 63048, 77003 for the same level -‐For insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, see 22869, 22870
New ● 22869 Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level
New ● +22870 Second level (List separately in addition to code for primary procedure)
-‐ Use with 22869 -‐Do not report either 22869 or 22870 with 22532-‐22534, 22558, 22612, 22614, 22630, 22632-‐22634,22800, 22802, 22804, 22840-‐22842, 63005, 63012, 63017, 63030, 63035, 63042, 63044, 63047, 63048, 77003
-
a b e o | W E K N O W C O D I N G .
Page 16
Pelvis and Hip Joint New and Deleted Codes Change Type
CPT Code
CPT Descriptor Change Detail
Deleted 27193 Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation -‐To report, see 27197, 27198
Deleted 27194 with manipulation, requiring more than local anesthesia
New ● 27197 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with manipulation
New ● 27198 With manipulation, requiring more than local anesthesia (ie, general anesthesia, moderate sedation, spinal/epidural)
-‐To report closed treatment of only anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral, use the appropriate evaluation and management services codes
Foot and Toes New, Revised, and Deleted Codes Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 28289 Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant
-‐ Wording has been added to include “without implant”
Deleted 28290 Correction, hallux valgus (bunion), with or without sesamoidectomy; simple exostectomy (eg, Silver type procedure)
-‐To report, see 28292
New ● 28291 Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant
Revised ∆ 28292 Correction, hallux valgus (bunion) (bunionectomy), with or without sesamoidectomy, when performed; with resection of proximal phalanx base, when performed, any method Keller, McBride, or Mayo type procedure
-‐Wording has significantly changed
Deleted 28293 Correction, hallux valgus (bunion), with or without sesamoidectomy; resection of joint with implant
-‐To report, use 28291
Deleted 28294 Correction, hallux valgus (bunion), with or without sesamoidectomy; with tendon transplants (eg, Joplin type procedure)
-‐To report, used 28899
-
a b e o | W E K N O W C O D I N G .
Page 17
New ●# 28295 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method
Revised ∆ 28296 with distal metatarsal osteotomy, any method (eg, Mitchell, Chevron, or concentric type procedures)
-‐Wording change
Revised ∆ 28297 with first metatarsal and medial cuneiform joint arthrodesis, any method; Lapidus-‐type procedure
-‐Wording change
Revised ∆ 28298 with proximal by phalanx osteotomy, any method -‐Wording change Revised ∆ 28299 with by double osteotomy, any method -‐Wording change
Other Procedures Parenthetical Note Under code 28890, a parenthetical note advises that for extracorporeal shock wave therapy involving the musculoskeletal system not otherwise specified, see 0101T or 0102T.
Respiratory System Moderate (Conscious) Sedation Revised Codes for This Section Change Type CPT
Code CPT Code
CPT Code
Change Detail
Revised ∆
31615 +31633 31653
-‐ Moderate sedation has been removed as an inclusive component of these procedures
31622 31634 +61354 31623 31635 31660 31624 31645 31661 31625 31646 31725 31626 31647 32405 +31627 +31651 32550 31628 31648 32551 31629 +31649 32553 +31632 31652
Larynx Endoscopy Guideline Addition Instruction is provided regarding what is included in the endoscopic examination has been provided.
New and Revised Codes Change Type
CPT Code
CPT Descriptor Change Detail
New ●# 31572 Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral
-‐Do not use with 31576 or 31578 -‐To report flexible endoscopic evaluation of swallowing, see 92612-‐92613 -‐To report flexible endoscopic evaluation with sensory testing, see 92614-‐92615
-
a b e o | W E K N O W C O D I N G .
Page 18
-‐To report flexible endoscopic evaluation of swallowing with sensory testing, see 92616-‐92617 -‐For flexible laryngoscopy as part of flexible endoscopic evaluation of swallowing and/or laryngeal sensory testing by cine or video recording, see 92612-‐92617
New ●# 31573 Laryngoscopy, flexible; with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral
New ●# 31574 Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral
Revised ∆ 31575 Laryngoscopy, flexible fiberoptic; diagnostic
-‐“Fiberoptic” has been removed from the code description
Revised ∆ 31576 with biopsy(ies) -‐In addition to the basic code revision, the plural has been added
Revised ∆ 31577 with removal of foreign body(s) -‐In addition to the basic code revision, the plural has been added
Revised ∆ 31578 with removal of lesion(s), non-‐laser -‐In addition to the basic code revision, the plural has been added along with the words “non-‐laser”
Revised ∆ 31579 Laryngoscopy, flexible or rigid fiberoptic telescopic, with stroboscopy
-‐“Fiberoptic” has been removed from the code description and “telescopic” has been added
Endoscopy Guideline Addition Instruction is provided regarding what is included in the endoscopic examination has been provided.
Revised Codes Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 31575 Laryngoscopy, flexible fiberoptic; diagnostic
-‐“Fiberoptic” has been removed from the code description
Revised ∆ 31576 with biopsy(ies) -‐In addition to the basic code revision, the plural has been added
Revised ∆ 31577 with removal of foreign body(s) -‐In addition to the basic code revision, the plural has been added
Repair New, Revised, and Deleted Codes
-
a b e o | W E K N O W C O D I N G .
Page 19
Change Type
CPT Code
CPT Descriptor Change Detail
New ●# 31551 Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age
-‐Do not report graft separately if harvested through the laryngoplasty incision (eg, thyroid cartilage graft) -‐Do not report with 31552-‐31554, 31580 -‐To report tracheostomy, see 31600, 31601, 31603, 31605, 31610
New ●# 31552 for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older
-‐Do not report graft separately if harvested through the laryngoplasty incision (eg, thyroid cartilage graft) -‐Do not report with 31552-‐31554, 31580 -‐To report tracheostomy, see 31600, 31601, 31603, 31605, 31610
New ●# 31553 for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age
-‐Do not report graft separately if harvested through the laryngoplasty incision (eg, thyroid cartilage graft) -‐Do not report with 31552-‐31554, 31580 -‐To report tracheostomy, see 31600, 31601, 31603, 31605, 31610 -‐To report removal of the stent, use 31599
New ●# 31554 for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older
-‐Do not report graft separately if harvested through the laryngoplasty incision (eg, thyroid cartilage graft) -‐Do not report with 31552-‐31554, 31580 -‐To report tracheostomy, see 31600, 31601, 31603, 31605, 31610 -‐To report removal of the stent, use 31599
Revised ∆
31580 Laryngoplasty; for laryngeal web, 2-‐stage, with indwelling keel or stent insertion and removal
-‐Significant wording change -‐Do not report with 31551-‐31554 -‐To report tracheostomy, see 31600, 31601, 31603, 31605, 31610 -‐To report removal of the keel or stent, use 31599
Deleted 31582 Laryngoplasty; for laryngeal stenosis, with graft or core mold, including tracheotomy
-‐To report, see 31551, 31552, 31553, 31554
Revised ∆
31584 with open reduction and fixation (eg, plating) of fracture, includes tracheostomy, if performed
-‐Indicates inclusion of tracheostomy and/or fixation -‐Do not report graft separately if harvested through the laryngoplasty incision (eg, thyroid cartilage graft)
Revised ∆
31587 Laryngoplasty, cricoid split, without graft placement
-‐ To report tracheostomy, see 31600, 31601, 31603, 31605, 31610
Deleted 31588 Laryngoplasty, not otherwise specified (eg, for burns, reconstruction after partial laryngectomy)
-‐To report laryngoplasty not otherwise specified, use 31599
New ● 31591 Laryngoplasty, medialization, unilateral
New ● 31592 Cricotracheal resection -‐Do not report graft separately if harvested through Cricotracheal resection incision (eg,
-
a b e o | W E K N O W C O D I N G .
Page 20
trachealis muscle) -‐Do not report local advancement and rotational flaps separately if performed through the same incision -‐To report tracheostomy, see 31600, 31601, 31603, 31605, 31610 -‐To report excision of tracheal stenosis and anastomosis, see 31780, 31781
Trachea and Bronchi Endoscopy Revised Codes Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 31615 Tracheobronchoscopy through established tracheostomy incision
-‐For tracheoscopy, see laryngoscopy codes 31515-‐31574
Cardiovascular System Moderate (Conscious) Sedation Revised Codes for This Section Change Type
CPT Code
CPT Code
CPT Code
CPT Code
CPT Code
CPT Code
CPT Code
CPT Code
Change Detail
Revised ∆
33010 33223 33282 36222 36555 36585 37214 37232
-‐ Moderate sedation has been removed as an inclusive component of these procedures
33011 33227 33284 36223 36557 36590 37215 37233 33206 33228 33990 36224 36558 36870 37216 37234 33207 33229 33991 36225 36560 37183 37218 37235 33208 33230 33992 36226 36561 37184 37220 37236 33210 33231 33993 36227 36563 37185 37221 37237 33211 33233 35471 36228 36565 37186 37222 37238 33212 33234 35472 36245 36566 37187 37223 37239 33213 33235 35475 36246 36568 37188 37224 37241 33214 33240 35476 36247 36570 37191 37225 37242 33216 33241 36010 35248 36571 37192 37226 37243 33217 33244 36140 36251 36576 37193 37227 37244 33218 33249 36147 36252 36578 37197 37228 37252
33220 33262 36148 36253 36581 37211 37229 37253 33221 33263 36200 36254 36582 37212 37230 33222 33264 36221 36481 36583 37213 37231
Parenthetical Guideline Added A parenthetical instruction has been added directing that for radiological supervision and interpretation to see 75600-‐75970.
-
a b e o | W E K N O W C O D I N G .
Page 21
Heart and Pericardium Transmyocardial Revascularization Parenthetical Note Added With the deletion of code 33400, following +33141 a parenthetical note has been added advising to use 33141 with 33390, 33391, 33404-‐33496, 33510-‐33536, 33542.
Electrophysiologic Operative Procedures Incision Parenthetical Note Revision Following 33255, +33256, +33258 and +33259 parenthetic notes have been revised to reflect the addition of new codes 33390 and 33391 to the list of Do Not Report codes. New Code
Change Type
CPT Code
CPT Descriptor Change Detail
New ● 33340 Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation
-‐Do not report with 93462 -‐Do not report with 93452, 93453, 93458,93459, 93460, 93461, 93531, 93532, 93533 unless catheterization of the left ventricle is performed by a non-‐transseptal approach for indications distinct from the left atrial appendage closure procedure -‐Do not report with 93451, 93453, 93456, 93460, 93461, 93530, 93531-‐93533 unless complete right heart catheterization is performed for indications distinct from the left atrial appendage closure procedure
Cardiac Valves Parenthetical Guideline Additions A parenthetical note was added stating that for multiple valve procedures to see 33390, 33391, 33404-‐33478 and to add modifier 51 to the secondary valve procedure code. Aortic Valve New, Revised and Deleted Codes Change Type
CPT Code
CPT Descriptor Change Detail
New ● 33390 Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, Valvotomy, debridement, debulking, and/or simple commissural resuspension)
New ● 33391 complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)
-‐Do not report with 33390
-
a b e o | W E K N O W C O D I N G .
Page 22
Deleted 33400 Valvuloplasty, aortic valve; open, with cardiopulmonary bypass
-‐To report, see 33390, 33391 Deleted 33401 Valvuloplasty, aortic valve; open, with inflow occlusion Deleted 33403 Valvuloplasty, aortic valve; using transventricular
dilation, with cardiopulmonary bypass Revised ∆ 33405 Replacement, aortic valve, open, with
cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
-‐“Open” has been added to the code description
Revised ∆ 33406 with allograft valve (freehand) -‐“Open” was added to the primary code which is also applicable to these codes Revised ∆ 33410 with stentless tissue valve
Combined Arterial-‐Venous Grafting for Coronary Bypass Parenthetical Revision Following code +33530, the instructional note has been revised reflecting the addition of new codes 33390 and 33391 as well as the deletions of 33400, 33401, and 33403.
Thoracic Aortic Aneurysm Parenthetical Revision Following 33864, the instructional note had been revised reflecting the deletion of 33400 from the list of Do Not Report codes. Heart/Lung Transplantation Parenthetical Revision Following 33944, the instructional note had been revised reflecting the deletion of 33400 from the list of Do Not Report codes. Cardiac Assist Parenthetical Additions To reflect the addition of new Category III codes, the following parenthetical notes have been added
• 33968 – For removal of implantable aortic counterpulsation ventricular assist system, see 0455T, 0456T, 0457T, or 0458T
• 33970 – For insertion or replacement of implantable aortic counterpulsation ventricular assist system, see 0451T, 0452T, 0453T, or 0454T
• 33971 – For removal of implantable aortic counterpulsation ventricular assist system, see 0455T, 0456T, 0457T, or 0458T
• 33973 – For insertion or replacement of implantable aortic counterpulsation ventricular assist system, see 0451T, 0452T, 0453T, or 0454T
• 33974 – For removal of implantable aortic counterpulsation ventricular assist system, see 0455T, 0456T, 0457T, or 0458T
• 33979 – For insertion or replacement of implantable aortic counterpulsation ventricular assist system, see 0451T, 0452T, 0453T, or 0454T
• 33980 – For removal of implantable aortic counterpulsation ventricular assist system, see 0455T, 0456T, 0457T, or 0458T
• 33983 – For insertion or replacement of implantable aortic counterpulsation ventricular assist system, see 0451T, 0452T, 0453T, or 0454T
Revised Codes
-
a b e o | W E K N O W C O D I N G .
Page 23
Change Type
CPT Code
CPT Descriptor Change Detail
Revised ∆ 33991 both arterial and venous access, with transseptal puncture
-‐This code has been revised with the removal of moderate sedation as an integral component of the procedure -‐ For insertion or replacement of implantable aortic counterpulsation ventricular assist system, see 0451T, 0452T, 0453T, or 0454T
Revised ∆ 33992 Removal of percutaneous ventricular assist device at separate and distinct session from insertion
-‐This code has been revised with the removal of moderate sedation as an integral component of the procedure -‐ For removal of implantable aortic counterpulsation ventricular assist system, see 0455T, 0456T, 0457T, or 0458T
Revised ∆ 33993 Repositioning of percutaneous ventricular assist device with imaging guidance at separate and distinct session from insertion
-‐This code has been revised with the removal of moderate sedation as an integral component of the procedure -‐For relocating and repositioning of implantable aortic counterpulsation ventricular assist system, see 0459T, 0460T, or 0461T
Arteries and Veins Fenestrated Endovascular Repair of the Visceral and Infrarenal Aorta Parenthetical Note Change To reflect the deletion of transluminal angioplasty codes 35452 and 35472, the following parenthetical notes have been revised:
• Do not report 34841-‐34844 with 34800, 34802-‐34805, 34845-‐34848, 75952 • Do not report 34845-‐34848 with 34800, 34802-‐34805, 34841-‐34844, 35081, 35102, 75952
Transluminal Angioplasty Open Deleted Codes Change Type
CPT Code
CPT Descriptor Change Detail
Deleted 35450 Transluminal balloon angioplasty, open; renal or other visceral artery
-‐To report see 36902, 36905, 36907, 37246, 37247, 37248, 37249
Deleted 35452 Transluminal balloon angioplasty, open; aortic
Deleted 35458 Transluminal balloon angioplasty, open; aortic
Deleted 35460 Transluminal balloon angioplasty, open; venous
Percutaneous Deleted Codes Change CPT CPT Descriptor Change Detail
-
a b e o | W E K N O W C O D I N G .
Page 24
Type Code
Deleted 35471 Transluminal balloon angioplasty, percutaneous; renal or visceral artery
-‐To report, see 36902, 36905, 36907, 37246, 37247, 37248, 37249
Deleted 35472 Transluminal balloon angioplasty, percutaneous; aortic
Deleted 35475 Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel
Deleted 35476 Transluminal balloon angioplasty, percutaneous; venous
Vascular Injection Procedures Intra-‐Arterial-‐Intra-‐Aortic Revised and Deleted Codes
Change Type CPT Code
CPT Descriptor Change Detail
Deleted 36147 Introduction of needle and/or catheter, arteriovenous shunt created for dialysis (graft/fistula); initial access with complete radiological evaluation of dialysis access, including fluoroscopy, image documentation and report (includes access of shunt, injection[s] of contrast, and all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava)
-‐To report, see 36901-‐36906
Deleted 36148 additional access for therapeutic intervention (List separately in addition to code for primary procedure)
Parenthetical Phrase only
+36218 -‐For angiography, see 36222-‐36228, 75600-‐75774 -‐For transluminal balloon angioplasty (except lower extremity artery[ies] for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), see 37246, 37247
Parenthetical Notes Added The same parenthetical note has been added under codes 36430, 36440, and 36450 advising that when a partial exchange transfusion is performed in a newborn to use new code 36456. New Codes
Change Type
CPT Code
CPT Descriptor Change Detail
New ● 36456 Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn
-‐Do not report with 36430, 36440, 36450
-
a b e o | W E K N O W C O D I N G .
Page 25
New ● 36473 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated
New ● +36474 subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure
-‐Use with 36473 -‐Do not report 36474 more than once per extremity -‐Do not report 36473, 36474 with 29581, 29582, 36000, 36002, 36005, 36410, 36425, 36475, 36476, 36478, 36479, 37241, 75894, 76000, 76001, 76937, 76942, 76998, 77022, 93970, 93971 in the same surgical field -‐For catheter injection of sclerosant without concomitant endovascular mechanical disruption of the vein intima, use 37799 -‐For catheter injection of an adhesive, use 37799
Revised ∆ +36476 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency mechanochemical; second and subsequent veins treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)
-‐Wording changed to reflect new parent codes 36473 and 36474 -‐Do not report more than once per extremity
Revised ∆ +36479 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)
-‐Wording changed -‐Do not report more than once per extremity
Guideline Notes Added New guidelines have been added to clarify the differences in modalities for treatment of incompetent veins. Sclerotherapy of telangiectasia and/or incompetent veins for codes 36468, 36470, and 36471 and endovascular ablation therapy of incompetent extremity veins for codes 36473, 36474, 36475, 36476, 36478, and 36479. Additional information is added regarding the reporting of imaging for these various codes. Hemodialysis Access, Intervascular Cannulation for Extracorporeal Circulation, or Shunt Insertion Arteriovenous Fistula Parenthetical Notes Added With the establishment of new dialysis circuit codes 36901-‐36909 and the deletion of 36870, parenthetical notes have been added following 36833.
-
a b e o | W E K N O W C O D I N G .
Page 26
Deleted Code Change Type CPT
Code CPT Descriptor Change Detail
Deleted 36870 Thrombectomy, percutaneous, arteriovenous fistula, autogenous or nonautogenous graft (includes mechanical thrombus extraction and intra-‐graft thrombolysis)
-‐To report percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis within the dialysis circuit, see 36904, 36905, 36906
Ø Dialysis Circuit New Subsection
New Guidelines With the addition of this subsection, definitions and guidelines have been added to direct the usage of the new codes.
New Codes Change Type
CPT Code
CPT Descriptor Change Detail
New ● 36901 Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report
-‐Do not report with 36833, 36902-‐36906
New ● 36902 with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty
-‐Do not report with 36903
New ● 36903 with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment
-‐Do not report 36902, 36903 with 36833, 36904-‐36906 -‐Do not report 36901-‐36903 more than once per operative session -‐For transluminal balloon angioplasty within central vein(s) when performed through dialysis circuit, use 36907 -‐For transcatheter placement of intravascular stent(s) within central vein(s) when performed through dialysis circuit, use 36908
New ● 36904 Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance,
-‐For open thrombectomy within the dialysis circuit, see 36831, 36833
-
a b e o | W E K N O W C O D I N G .
Page 27
catheter placement(s_, and intraprocedural pharmacological thrombolytic injection(s)
New ● 36905 with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty
-‐Do not report with 36904
New ● 36906 with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit
-‐Do not with 36901-‐36905 -‐Do not report 36904-‐36906 more than once per operative session -‐For transluminal balloon angioplasty within central vein(s) when performed through dialysis circuit, use 36907 -‐For transcatheter placement of intravascular stent(s) within central vein(s) when performed through dialysis circuit, use 36908
New ● +36907 Transluminal balloon angioplasty, central dialysis segment performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (List separately in addition to code for primary procedure)
-‐Use with 36818-‐36833, 36901-‐36906 -‐Do not report with 36908 -‐Report once for all angioplasty performed within the central dialysis segment
New ● +36908 Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)
-‐Use with 36818-‐36833, 36901-‐36906 -‐Do not report with 36907 -‐Report once for all stenting performed within the central dialysis segment
New ● +36909 Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (List separately in addition to code for primary procedure)
-‐Includes all permanent vascular occlusions within the dialysis circuit and may only be reported once per encounter per day -‐Report with 36901-‐36909 -‐For open ligation/occlusion in dialysis access, use 37607
Transcatheter Procedures Revised Codes
Change Type CPT Code
CPT Descriptor Change Detail
Revised ∆ 37184 Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-‐intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial
-‐Parenthetical note changed to: Do not report with 61645, 76000, 76001, 96374, 99151-‐99153, 99155-‐99157 -‐This code has been revised
-
a b e o | W E K N O W C O D I N G .
Page 28
vessel with the removal of moderate sedation as an integral component of the procedure
Parenthetical Note Revision
37217 Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation
-‐Do not report with 35201, 36221-‐36227, 37246, 37247
Endovascular Revascularization (Open or Percutaneous, Transcatheter) Guideline Note Revisions With the addition of the new dialysis circuit codes, the guidelines for new codes 37246-‐37249 have undergone extensive revision to reflect the additions with cross referencing parenthetical notes.
New and Revised Codes Change Type CPT
Code CPT Descriptor Change Detail
New ●# 37246 Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery
New ●# +37247 each additional artery (List separately in addition to code for primary procedure)
-‐Use with 37246 -‐Do not report 37246, 37247 with 37215-‐37218, 37220-‐37237 when performed in the same artery during the same operative session -‐Do not report 37246, 37247 with 34841-‐34848 for angioplasty(ies) performed, when placing bare metal or covered stents into the visceral branches within the endoprosthesis target zone
New ●# 37248 Transluminal balloon angioplasty (except dialysis circuit) open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein
New ●# +37249 each additional vein (List separately in addition to code for primary procedure)
-‐Use with 37248 -‐-‐Do not report 37248, 37249 with 37238, 37239 when performed in the same vein during the same operative session -‐For transluminal balloon angioplasty in aorta/visceral artery(ies) in conjunction with fenestrated endovascular repair, see
-
a b e o | W E K N O W C O D I N G .
Page 29
34841-‐34848 -‐For transluminal balloon angioplasty in iliac, femoral, popliteal, or tibial/peroneal artery(ies) for occlusive disease, see 37220-‐37235 -‐For transluminal balloon angioplasty in a dialysis circuit performed through the circuit, see 36902-‐36908 -‐For transluminal balloon angioplasty in an intracranial artery, see 61630, 61635 -‐For transluminal balloon angioplasty in a coronary artery, see 92920-‐92944 -‐For transluminal balloon angioplasty in a pulmonary artery, see 92997, 92998
Revised ∆ 37236 Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery
-‐The guideline preceding this code indicates the consideration of the new dialysis circuit when performed through the dialysis circuit -‐This code has been revised with the removal of moderate sedation as an integral component of the procedure
Revised ∆ Parenthetical Note Added
+37237 each additional artery (List separately in addition to code for primary procedure)
-‐For placement of a stent at the arterial anastomosis of a dialysis circuit with or without transluminal mechanical thrombectomy and/or infusion for thrombolysis, see 36903, 36903 -‐This code has been revised with the removal of moderate sedation as an integral component of the