ED Coding and Reimbursement Alert

You’ll find 394 total code changes effective Jan. 1.

Coding spinal punctures performed in the ED may be a little bit more straightforward effective Jan. 1. That’s because CPT^® will be adding two new codes that allow you to clarify when guidance is used during the service.

Background: The 2020 CPT^® code set was recently released, with 394 code changes that include a startling 248 new codes, as well as 75 revised descriptors and 71 deletions.

“An annual editorial process draws insight from the entire health care community to produce practical code enhancements to CPT^® that support advancements in technology and medical knowledge available for the care of patients,” said AMA President Patrice A. Harris, MD in a statement about the new codes.

Pinpoint These New Spinal Puncture Codes

Of relevance to emergency departments are two new codes describing spinal puncture. The Relative Value Scale Update Committee (RUC) recently reviewed this code family for reevaluation and determined that two additional codes describing spinal puncture with guidance were needed. The new codes, which will go into effect Jan. 1, are:

• 62328 (Spinal puncture, lumbar, diagnostic; with fluoroscopic or CT guidance)
• 62329 (Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or CT guidance)

Most emergency physicians will typically report the current code 62270 (Spinal puncture, lumbar, diagnostic), but since this code does not mention fluoroscopic or CT guidance, physicians who used it in the past either had to separately report guidance or would forego payment for the guidance service.

Digital codes added: Many of the remaining new codes that the AMA added involve a way to report visits performed via electronic methods such as patient portals. However, because these codes refer to “established patients,” they won’t help EDs, since there is no distinction between new and established patients from a coding perspective when services are performed in the emergency department.