General Surgery Coding Alert

13150 and 15777 changes need your attention.

Although they may pale by comparison to the virtual re-write of the esophagus surgery section and the vast changes to vascular surgery codes, you can’t afford to miss two changes for codes you might commonly use in your surgery practice.

You can read about those big changes in past and future issues of General Surgery Coding Alert with articles such as “Prepare for CPT® 2014 Esophagoscopy Overhaul” (Vol. 15 No. 12) — but read this to learn about two small changes you need to know.

Strike 13150 and Revise Code Family

CPT® 2014 deletes parent code 13150 (Repair, complex, eyelids, nose, ears and/or lips; 1.0 cm or less) and revises the associated codes to make 13151 the parent code, as follows:

• 13151 — Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
  
• 13152 — … 2.6 cm to 7.5 cm
  
• +13153 — … each additional 5 cm or less (List separately in addition to code for primary procedure).
  

A text note following the deletion note for 13150 states, “for 1.0 cm or less, see simple or intermediate repairs.”

Rationale: The thought was that so few of these codes [13150] were reported annually, only about 2500, that the code was not necessary. A complex repair so small would be hard pressed to meet the CPT® definition of a layered closure requiring debridement and extensive undermining, says Michael A. Granovsky, MD, FACEP,

CPC, President of LogixHealth, a medical coding and billing company in Bedford, MA.

Breast and Trunk is All for 15777

Another small surgery change involves replacing a tiny abbreviation — but that little change alters the code usage substantially.

CPT® 2014 changes the +15777 definition to Implantation of biologic implant [i.e., acellular dermal matrix] for soft tissue reinforcement (i.e., breast, trunk) (List separately in addition to code for primary procedure).

The only change is to remove “e.g.” (abbreviation for the Latin phrase exempli gratia, which means “for example”) and change it to “i.e.” (abbreviation for the Latin phrase id est, which means “that is”).

Upshot: The implication of this revision is that you should now only report these implants when applied to the breast or trunk, says Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.

Alternative: A new text note following +15777 states, “For implantation of biologic implants in soft tissues other than breast and trunk, use 17999.”