You Be the Coder:
Implementing CPT 2000 Codes
Published on Wed Mar 01, 2000
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: I used code 62289 (injection of substance other than anesthetic, antispasmodic, contrast, or neurolytic solutions; lumbar or caudal epidural [separate procedure]) for the whole month of January, then learned from your newsletter that the code was deleted in CPT 2000. Will I get denials on all of the claims including this code or is there a time frame allowed for the changeover from CPT 1999 to CPT 2000?
Donna Grimes, Practice Manager
Neurosurgical Group Greater Louisville and South Illinois
Louisville, Ky.
Answer: Code 62289 has been replaced by code 62311 (injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]).
Eric Sandham, CPC, compliance educator for Central California Faculty Medical Group, a group practice and training facility associated with the University of California at San Francisco in Fresno, reports that some carriers may have a crosswalk feature in their insurance claim processing software. If so, the program will read a CPT 1999 code and automatically re-assign a CPT 2000 code designation. These programs are set up to operate in this manner until March 31, 2000.
As several now-deleted codes have been combined into 62311, this code has a higher relative value than 62289. Sandham reports that if the payer has a crosswalk function programmed into its claims processing software, the neurosurgeon should get paid at the new rate, even when using the old code, until April 1.
Cindy Parman, CPC, CPC-H, principal and co-founder of Coding Strategies, Inc., a Dallas, Ga.-based consulting firm and an advisory board member for the American Academy of Professional Coders, says that not all payers may have crosswalk programming in their claims processing software. If not, claims using older codes may still be paid at the previous rates.
Parman, who worked for a commercial insurance payer for 20 years, further reports that with some third-party payers claims that arrive with new coding may be pended until the payer is ready to update to the new codes. Medicare carriers generally require the implementation of CPT 2000 codes effective April 1. Medicare carriers usually will send out a notice before the end of the year reminding providers that there is a grace period and the new codes should be implemented as of April 1. A subsequent reminder may be sent to providers again some time in February or March. At this time, providers are informed that the new codes will be effective April 1 or on an earlier date [...]
