New year, new CPT modifications part 2

Feb. 5, 2016 / By Rebecca Caux-Harry

Picking up where we left off last month, here’s part two of my blog on CPT additions, deletions and modifications for 2016 (for part one, click here). Let’s start in the Urinary System with a new introduction under Other Introduction (Injection/Change/Removal) Procedures. Like other updates, deleted component codes are replaced with new codes reporting both the insertion procedure and supervision and interpretation services. Deleted for 2016 are CPT codes 50392-50394, and 74475-74480, and new codes 50430-50435, 50606, 50693-50695 and 50705-50706 have been added. For example:

50432 Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg. Ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation

50606 Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg. Ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

Each of the new codes is reported once for each renal collecting system/ureter accessed.

There are new codes to report percutaneous therapeutic intervention in the intracranial arteries including thrombectomy and thrombolysis. These codes, like other new codes, bundle multiple services into a single code. Codes 61645-61651 include selective catheterization, diagnostic and all subsequent angiography, as well as radiological supervision and interpretation within the treated vascular territory, fluoroscopic guidance, neurologic and hemodynamic monitoring and closure of the access site. For reporting purposes, the intracranial arteries are divided into three groups, right carotid circulation, left carotid circulation and vertebro-basilar circulation. Additional reporting direction can be found in the CPT manual prior to the new codes.

For those of you working in a Pediatric office, you have a new code for impacted ear wax removal via lavage. Previously, this service was considered part of the E&M service and not reported separately. Note that the term “impacted” is part of the CPT descriptor. For cerumen that is not impacted, use the appropriate E&M code.

               69209 Removal impacted cerumen using irrigation/lavage, unilateral

A subtle but very important change has been made to a variety of radiologic codes, changing the word “film(s)” to “image(s)” to reflect the transition to digital imaging. In the Radiology Guidelines section of the CPT book, under Written Report(s) the book states, “With regard to CPT descriptors for radiography services, ‘images’ refer to those acquired in either an analog (ie, film) or digital (ie, electronic) manner.” Codes impacted by this change are 74240-74247, 74250-74251, 74340, 77057 and 77417.

There have been 23 deletions and 21 additions in the Radiology section. Deleted codes include 70373, 72010, 72069, 72090, 73500-73520, 73530-73550, 74305-74327, 75896, 75945, 75946, 75980, 75982 and 77776-77787.   Hip and pelvis x-rays have been bundled together with the addition of 6 new codes, 73501-73523, for example:

               73521 Radiologic examination, hips, bilateral, with pelvis when performed; 2 views

Other new codes in the Radiology section include thoracolumbar spine x-rays 1 view up to 6 views, 72081-72084, new femur x-ray codes 73551-73552, and new fetal MRI codes 74712 and 74713 based on number of fetuses, replacing the unlisted procedure code used in prior years.   The remaining new Radiology codes, 77767-77772 in the Clinical Brachytherapy section report remote afterloading high dose rate radionuclide brachytherapy.

There have been many revisions to the pathology and laboratory sections as well as the Vaccine codes to reflect changes in medicine including many editorial changes, new codes and deletion of obsolete codes. Please review these updates carefully. As always, refer to your CPT manual for specific coding descriptors and coding direction. Happy coding.

Rebecca Caux-Harry, CPC, is the CodeRyte product specialist for cardiology with 3M Health Information Systems.

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