General Surgery Coding Alert

Catheter changes lead the charge.

You’ll be using CPT^® 2013 codes before you know it, so let our experts give you a crash course in what’s new for the coming year that might impact your general surgery practice .

Big change: “Continuing the trend to revise catheter coding (CPT^® 2012 revised 36245-36248 and added 36251-36254, Selective catheter placement…), CPT^® 2013 revises, adds or deletes 18 catheter-related codes,” says Marcella Bucknam, CPC, CPC-I, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, audit manager for CHAN Healthcare in Vancouver, Wash.

Check-Out This Quick-Reference Synopsis

Peruse this 10-bullet summary to see what’s coming your way in CPT^® 2013:

·         Island pedicle flap change: Expect a revision to 15740 (Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel) that distinguishes the code from 14000-14302 (for adjacent area flaps without clearly defined anatomically named axial vessels).

·         Fluid removal from chest: CPT^® 2013 deletes pneumocentesis and thoracentesis codes 32420-32422, and adds new codes for pleural aspiration (32554-32555, Thoracentesis, needle or catheter, aspiration of the pleural space…) and pleural drainage (32556-32557, Pleural drainage, percutaneous, with insertion of indwelling catheter…) to take their place. Tube thoracostomy 32551 revision specifies that it’s an open procedure. You’ve already read about these changes in “32420-32422 Are Out -- Prep 4 New Thoracentesis and Drainage Codes,” General Surgery Coding Alert Vol. 14, No. 12.

·         Catheter introduction: Codes for vena cava (36010) and extremity artery (36140) catheter introduction will include moderate sedation in CPT^® 2013.

·         Cervical, cerebral, and carotid selective catheter placement: Expect to see eight new codes (36221-+36228, Non-selective/selective catheter placement…), each of which represents both catheter placement and radiological services. Because the new codes include angiography, 75650-75685 will be deleted. Read more about this change in “8 New Codes Merge Catheter Placement + Angiography” on page xxx of this issue.

·         Venipuncture changes: Revisions to 36400-36410 (Venipuncture …) allow “other qualified health care professionals” to perform the service, not just physicians.

·         Transcatheter foreign body retrieval: New code 37197 (Transcatheter retrieval, percutaneous, of intravascular foreign body [e.g., fractured venous or arterial catheter], includes radiological supervision and interpretation, and imaging guidance [ultrasound or fluoroscopy], when performed) includes both transcatheter retrieval and imaging. Consequently, CPT^® will delete transcatheter retrieval code 37203 and its related code 75961.

·         Transcatheter therapy infusion: Thrombolysis codes 37201 (therapy) and 37209 (catheter exchange) that CPT^® 2013 deletes are replaced with several more specific, comprehensive codes 37211-37214 (Transcatheter therapy…).

·         Transplantation cellular infusions: New and revised CPT^® instruction and codes 38240-38242 (HPC/Allogeneic lymphocyte…) clarify coding for cellular infusions of hematopoietic and other cells.

·         Optical endomicroscopy: You’ll have two new codes -- 43206 and 43252 -- to describe optical endomicroscopy to report high-resolution imaging during esophageal and upper gastrointestinal endoscopy.

Emerging technology category III codes: Capture extracorporeal shock wave for integumentary wound healing with 0299T-0300T, and malignant breast tumor microwave destruction/reduction with 0301T.