General Surgery Coding Alert

Hint: You don’t have to stay in your section of the book.

If you’ve ever wondered whether your general surgeon is limited to performing services from certain sections of CPT® or if other providers can venture into “your” territory, CPT® 2014 has the answers for you.

According to a new CPT® 2014 introduction, healthcare techniques and procedure have evolved in a way that challenges the traditional distinction of surgery versus medicine. “Thus, the listing of a service or procedure in a specific section of this book should not be interpreted as strictly classifying the service or procedure as ‘surgery’ or ‘not surgery,’” states the CPT® 2014 introduction.

Plus: New language in the introduction also explains that “When advanced practice nurses and physician assistants are working with physicians, they are considered as working in the exact same specialty and exact same subspecialties as the physician.” Further, “A ‘physician or other qualified health care professional’ is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.”

Translation: This new language reinforces the CPT® principal that any procedure or service in the book may be used by any qualified health care professional, says Michael Granovsky MD, CPC, President of LogixHealth, an ED billing company in Bedford MA.

AMA Opens Update Requests

Although for years, practicing physicians, medical specialty societies, state medical associations, and other organizations and agencies have been welcome to suggest changes to the CPT® code set, a change in the introduction opens the field even wider.

New language adds “individual users of the CPT® code set and other stakeholders” to the list of those eligible to correspond with the AMA regarding “coding and nomenclature for old and new procedures and services, as well as any matters relating to the CPT® code set.” You’ll also find instructions about how to make a comment in the introduction.