Ob-Gyn Coding Alert

CPT 2003, which goes into effect Jan. 1, 2003, offers several changes to surgical codes that affect ob/gyn procedure reporting, including those associated with lesion removal, abdominal and bladder surgeries, and colposcopies, among others. Although this article references specific changes that affect ob-gyn coders, it may not be a complete listing. You should review CPT 2003 to familiarize yourself with all the coding changes that may affect your practice. Skin Lesions "The skin lesion codes have been revised in 2003 to clearly state that they describe a full-thickness removal of the lesion, which includes the margin along with simple closure (if performed)," says Melanie Witt, RN, CPC, MA, an independent coding consultant and educator based in Fredericksburg, Va. "In other words, you should pick the code based on the total amount of tissue removed at that site during the operative session, not just the lesion size." 11420 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less 11421 excised diameter 0.6 to 1.0 cm 11422 excised diameter 1.1 to 2.0 cm 11423 excised diameter 2.1 to 3.0 cm 11424 excised diameter 3.1 to 4.0 cm 11426 excised diameter over 4.0 cm 11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less 11621 excised diameter 0.6 to 1.0 cm 11622 excised diameter 1.1 to 2.0 cm 11623 excised diameter 2.1 to 3.0 cm 11624 excised diameter 3.1 to 4.0 cm 11626 excised diameter over 4.0 cm. Blood Work Collection CPT 2003 revises 36415 (Collection of venous blood by venipuncture) and adds 36416 (Collection of capillary blood specimen [e.g., finger, heel, ear stick]) to better assign blood collection methods and to delete G0001 (Routine venipunc-ture for collection of specimen[s]). "G codes are Medicare codes, not CPT codes," says Terry Tropin, RHIA, CPC, CCS-P, manager of coding education for the American College of Obstetricians and Gynecologists. Therefore, many private payers do not recognize them. Several G codes, as well as other HCPCS codes, have been replaced with CPT codes to make coding for these services more uniform. Abdominal Procedures Gynecological oncologists who perform intraperi-toneal chemotherapy in women with ovarian or primary peritoneal cancer may report the new code 49419 (Insertion of intraperitoneal cannula or catheter, with subcutaneous reservoir, permanent [i.e., totally implantable]; for removal, use 49422). When this procedure is performed, it requires an incision and the creation of a pocket for the reservoir. Bladder CPT 2003 has developed three new codes to replace G0002 (Office procedure, insertion of temporary indwelling catheter, Foley type [separate procedure]). "You would report these codes only when the catheter insertion is an independent procedure, not when the insertion [...]