The first two of these new codes include the primary code 96112 for developmental test administration, and the add-on code +96113 to report each additional 30 minutes beyond the hour indicated in 96112. Guidelines also direct that the codes are selected based in guidance included and add on-codes for each additional lesion, same imaging modality. We'll cover the diagnostic codes first and then go into detail about the interventional coding changes. Additional codes will be available to report test administration and scoring. When using different imaging modalities when more than one lesion is involved, Modifier 59 is appended. The new codes 11102-11107 for skin biopsies based on method of removal including tangential shave, scoop, saucerize, curette , punch and incisional.
Guidelines also direct that the codes are selected based in guidance included and add on-codes for each additional lesion, same imaging modality. The second new code, 33286, depicts the removal of the monitor. Also, new add-on codes were added for when more than one distinct lesion was treated. New guidelines were created to help with coding and reporting of these codes. .
You may combine the new codes to report biopsy by various methods. Magnetic resonance elastography is new diagnostic imaging technology. New code 53854 describes the use of radiofrequency energy to transform sterile water into vapor steam. When multiple biopsies are performed via different methods, report one primary code and use an-add on based on biopsy method for each additional biopsy on the same date. Conclusion The bundling of imaging guidance and the supervision and interpretation of the exam into a single code for the entire procedure continues to be the major theme of these revisions.
When the full thickness of the dermis is involved the procedure reported is 11300-11313 removal of epidermal or dermal lesions. Buck how to polish up your diagnosis coding for the new, revised and deleted codes—including guideline changes. New add-on code 33866 reports aortic hemiarch graft when performed in addition to an ascending aortic graft 33860, 33863, or 33864 , when ascending aortic disease involves the aortic arch. In the Ophthalmology section, new codes 92273 and 92274 were added. Codes are selected based on the nerve selected and simple versus complex. The codes are based on medical consultative time. Radiology Added codes 76978-76979 report ultrasound procedures that use dynamic microbubble-sonographic contrast with targeted ultrasound to evaluation lesions.
Incisional Biopsy An incisional biopsy requires the use of a sharp blade not a punch tool to remove a full-thickness sample of tissue via a vertical incision or wedge, penetrating deep to the dermis, into the subcutaneous space. Gastrostomy The coding for the percutaneous change of a gastrostomy tube has been expanded. Learn from expert speaker Stacie L. There are new guidelines for coding biopsies and six new codes. Here, again, these four codes consist of two pairs, with one primary code and one add-on code to allot for addition time spent on the evaluation. Changes were made to the gastrostomy tube placement codes. Cardiovascular System New codes are added to describe implantation 33274 and removal 33275 of permanent leadless pacemakers, as well as the implantation 33285 and removal 33286 of subcutaneous cardiac rhythm monitor, and implantation of a wireless pulmonary artery pressure sensor 33289.
They apply to non-cardiac targeted dynamic microbubble sonographic contrast characterization. Ultrasound There are two areas of change in ultrasound, with new codes added for targeted dynamic microbubble sonographic contrast characterization and for elastography. The resulting data is used to manage patient care and treat symptoms such as bradykinesia, dyskinesia, and tremor. When a biopsy is performed on different lesions or different sites on the same day, each biopsy may be performed separately as they are not considered components of other procedures. Each practice has to evaluate any fee schedule changes in light of its mix of modalities and procedure volume.
Report 76978 for the initial lesion targeted and +76979 with 76978 to report additional lesion s targeted, beyond the first. These codes included all methods of removal. Digestive System Code 43760 is deleted and replaced by two new codes that define simple versus complex replacement of a percutaneous gastrostomy tube: 43762 for percutaneous replacement of gastrostomy tube without imaging or endoscopy and 43763 for percutaneous replacement of gastrostomy tube with removal when performed without imaging or endoscopy. Report one code per lesion biopsied. Punch Biopsy A punch biopsy required a punch tool to remove a full thickness cylindrical sample of the skin.
New codes 99451 and 99152 were added to report assessment and management services. Nearly every section in the code book has updates: The stakes are high that your coding is affected. Musculoskeletal System New add-on codes will allow clinicians to report osteoarticular 20932 , hemicortical partial intercalary 20933 , and complete intercalary 20934 allografts in addition to tumor removal procedures. Remember all excision codes include a biopsy so a separately biopsy code on the same structure is not appropriate. These services must include an interpretation and report when performed by a qualified provider. These new codes distinguish reporting, per organ, first target lesion and each additional target lesion. This type of biopsy does not involve the full thickness of the dermis.
Deborah is also the 2017 American Health Information Management Literacy Legacy Award Recipient. Other codes in this section 99446-99449 and 99091 were revised. Codes are selected based on age. They are vast and significant, and can make or break the success of your claims. Codes changed along with a reduction in reimbursement. The new codes 11102-11107 for skin biopsies based on method of removal including tangential shave, scoop, saucerize, curette , punch and incisional. New code changes number 335.
Use new add-on code +96121 to report each additional hour required to perform and interpret the neurobehavioral status exam. Similarly, new codes 0525T-0532T describe services related to intracardiac ischemia monitoring system, an implantable electrogram device that records cardiac data and detects ischemic events by way of an intracardiac lead in the right ventricular apex. Urinary System Code 50395 is deleted and replaced by two new codes: 50436 describes enlargement of an existing percutaneous tract to the renal collecting system to allow the use of instruments used during an endourologic procedure; 50437 reports the same service with the addition of new access into the renal collecting system during the same session, if there is no pre-existing tract. Medicine A new vaccine product for influenza virus gains a code, 90689. These are eletroretinography procedures to evaluate function of the retina and optic nerve of the eye. Also, ensure that you understand the requirements for medical necessity for radiology—specifically for diagnostic radiology reports—so you can correctly code services and capture appropriate payments.